当施設の大腸内視鏡における腺腫, 粘膜内癌, 浸潤癌別に比較した男女差の検討 Gender Differences between Patients with Colorectal Adenoma, Intramucosal Cancer, and Invasive Cancer Detected by Colonoscopy

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著者

    • 工藤 敏啓 KUDOH Toshihiro
    • 弘前大学消化器血液内科 Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine
    • 相沢 弘 AIZAWA Hiroshi
    • 弘前大学消化器血液内科 Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine
    • 福田 真作 FUKUDA Shinsaku
    • 弘前大学消化器血液内科 Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine

抄録

大腸癌は高齢になると女性の比率が増加し,女性では右側癌の比率が多い現象の分析を試みた.内視鏡検査を受けた大腸腫瘍患者1,004例(腺腫のみ598例,1個以上の粘膜内癌185例,1個以上の浸潤癌221例)を男性638例(M群)と女性366例(F群)に分類した.平均年齢は腺腫群がM群63.3歳,F群67.6歳,粘膜内癌群はM群66.2歳,F群70.1歳,浸潤癌群はM群68.5歳,F群71.8歳であり,いずれもF群が高齢だった(p<0.05).腺腫: 粘膜内癌: 浸潤癌の比率はM群 60.7%:19.4%:19.9%,F群 57.6%:16.7%:25.7%であり,F群はM群より浸潤癌のみ高率だった(p<0.05).近位腫瘍と遠位腫瘍の比率はM群は腺腫48.3%vs 51.7%,粘膜内癌37.0%vs 62.9%,浸潤癌29.1%vs 70.9%であり,腫瘍が進行するほど遠位側移動した(p<0.005).F群は腺腫48.8%vs 51.2%,粘膜内癌41.0%vs 59.0%,浸潤癌43.6%vs 56.4%であり,遠位側移動はなかった.以上から女性は男性より高齢で近位側の浸潤癌を発症しやすいと考えられる.<br>

Women have a higher incidence of colorectal cancer in older ages and have a greater number of proximal cancers compared to men. In order to evaluate these phenomena we analyzed gender differences between patients with colorectal adenoma, intramucosal cancer, and invasive cancer. A total of 1,004 patients with pathologically evaluated colorectal neoplasms during colonoscopy was included in the study. They consisted of 598 with adenoma(s) only (group A), 185 with at least one intramucosal cancer (group B), and 221 with at least one invasive cancer (group C). In groups A, B, and C the statistical comparisons between male and female were made with regard to the mean age, the proportion of patient number, and the proportion between proximal and distal colon neoplasms divided at the junction of the sigmoid-descending colon. Overall, 638 male (63.6%) and 366 female (36.5%) patients were identified, and females (69.2±10.2 yr) were older than males (65.0±10.4 yr) (p<0.0001). The mean ages in each group were 63.3 yr (male) and 67.6 yr (female) in group A, 66.2 yr and 70.1 yr in group B, and 68.5 yr and 71.8 yr in group C, respectively. Females were older than males in all groups (p<0.05). The proportions of patient number between groups A, B, and C were 60.7%: 19.4%: 19.9% in males and 57.6%: 16.7%: 25.7% in females. Females were more likely to have invasive cancer than males (p<0.05), although females with adenoma and/or mucosal cancer were less frequent. The proportions between proximal and distal neoplasms were 48.3%: 51.7% (male), 48.8%: 51.2% (female) in group A, 37.0%: 62.9%, 41.0%: 59.0% in group B, and 29.1%: 70.9%, 43.6%: 56.4% in group C, respectively. Progression from adenoma to invasive cancer led to a distal shift of neoplasms only in males (p<0.0005), although the same shift was not evident in females. In conclusion, a full colonoscopy to examine the deeper region of the colon is essential especially to detect proximal invasive cancer particularly in elderly females.<br>

収録刊行物

  • 日本大腸肛門病学会雑誌

    日本大腸肛門病学会雑誌 61(6), 333-338, 2008-06-01

    The Japan Society of Coloproctology

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