colorectal cancer
Introduction
Introduction to colorectal cancer Knot and rectal cancer are common malignant tumors in China. It accounts for the fourth place in China's malignant tumors and has an upward trend. Chinese epidemiological and rectal cancer have three epidemiological characteristics compared with Westerners: 1 Rectal cancer has a higher incidence than colon cancer, about 1.5:1; 2 Low rectal cancer accounts for a high proportion of rectal cancer, accounting for about 75%. Most rectal cancers can be detected during rectal examinations; 3 young people (<30 years old) have a higher proportion, accounting for about 15%. However, in recent decades, with the improvement of people's living standards and changes in dietary structure, the proportion of colon cancer has gradually increased. The treatment of colorectal cancer is the first choice for surgical removal of cancer, supplemented by radiotherapy, chemotherapy and traditional Chinese medicine. Recently, many scholars have used endoscopic resection for early colorectal cancer, and achieved good results. basic knowledge The proportion of illness: the incidence rate is 0.1%--0.3% Susceptible people: more than 40 years old Mode of infection: non-infectious Complications: blood in the stool, constipation
Cause
Causes of colorectal cancer
Dietary factors (35%):
High-fat, high-meat, low-fiber diet is closely related to the occurrence of rectal cancer. High-fat diet can not only stimulate the increase of bile secretion, but also promote the growth of certain anaerobic bacteria in the intestine. The anaerobic bacteria are decomposed by cholesterol and bile salts. The formation of unsaturated cholesterol, such as deoxycholic acid and lithocholic acid, is increased in the intestinal tract. The latter two are carcinogenic or co-cancer substances, which can lead to the occurrence of rectal cancer.
Genetic factors (25%):
About one in four families of rectal cancer patients have a family history of cancer, and half of them are also digestive tract tumors. Due to the change of the genes of normal cells, the cancer patients have a susceptibility to inheritance, and some stimulating factors, so that the tissue cells grow rapidly, they will develop into cancer, and the genetic mutations of the cells become tumor genetic characteristics. The malignant cells are characterized by the familial nature of the cancer.
Polyps (20%):
The incidence of rectal cancer is closely related to polyps. Some people think that rectal polyps are precancerous lesions of cancer, especially familial multiple adenomatous polyposis, and the possibility of canceration is great; papillary adenomatous polyps have more chances of canceration.
Chronic inflammatory irritation (10%):
Chronic inflammatory stimuli can cause rectal cancer. Such as schistosomiasis, amoebic dysentery, chronic non-specific ulcerative colitis, chronic bacillary dysentery, etc., can be cancerous through the granuloma, inflammatory and pseudo polyp stages. Patients with ulcerative colitis for more than 10 years are prone to evolution, and the degree of malignancy is high, easy to metastasize, and the prognosis is poor. According to statistics, the incidence of colitis in patients with intestinal cancer is lower than that without colitis. 8 to 10 times higher.
In addition, the occurrence of tumors is also closely related to mental factors, age, endocrine factors, environmental stress, climatic factors, immune dysfunction and viral infections, but rectal cancer can still occur under certain conditions.
Prevention
Colorectal cancer prevention
1, regular occult blood test:
For the early detection and diagnosis of various gastrointestinal hemorrhagic diseases, especially colorectal cancer, the occult blood test is:
· Internationally accepted screening method for colorectal cancer;
· The American Cancer Society (ACS) widely recommended "conventional inspection program for healthy people's group inspections";
· China's "Technical Program for Early Diagnosis and Early Treatment of Colorectal Cancer" specifically pointed out "the most valuable early screening index for colorectal cancer";
At present, the occult blood test has not been rigidly adhered to the traditional detection in the past. The domestic technology has been introduced in the country - the household occult blood test strip can be easily self-checked at home.
2, more sports: do not sit for long periods of time, do not exercise, and more outdoor sports.
3, diet Note: Eat less cold spicy spicy food.
Complication
Colorectal cancer complications Complications, blood in the stool, constipation
Colorectal cancer invades surrounding tissues and organs, gastrointestinal cancer, etc.
Symptom
Colorectal cancer symptoms Common symptoms Paroxysmal abdominal pain Diarrhea Indigestion Bloody constipation Ascites bloating Abdominal tenderness Abdominal pain Weight loss
First, early symptoms
Rectal cancer lacks symptoms at an early stage and the patient has no obvious abnormal changes. When the mass reaches 1 to 2 cm, due to the erosion of the tumor, the intestinal mucosa is subjected to foreign body stimulation of the mass and the secretion is increased. Therefore, a small amount of mucus is discharged during defecation, and most of it is attached to the front end of the stool or outside the stool. As the tumor grows, the secretory mucus also increases. Sometimes, as the venting or sudden coughing increases in the intra-abdominal pressure, mucus may flow out of the anus. When the tumor enlarges, forms an ulcer, or has necrotic infection, there will be obvious symptoms of rectal irritation, changes in the number of bowel movements and fecal properties. The number of bowel movements increased, 2 to 3 times a day, showing mucus, loose stools, mucus and blood. Often misdiagnosed as "enteric inflammation", "dysentery", "ulcerative colitis" and so on. However, the symptoms of rectal cancer and diarrhea are not as colitisary as they are, and they are getting better and faster. They are not as typical as dysentery. The symptoms of rectal irritation of rectal cancer are slow and gradual progress. Symptoms are obvious when combined with infection. Once symptomatic treatment, it can be temporarily improved. However, after a long period of treatment, mucus and bloody stools should be given enough attention. When the patient has the following conditions, he should go to the hospital for a detailed examination.
1 abnormal bowel habits, increased frequency of bowel movements, a small amount of mucous stools, mucus and bloody stools, those who are not well treated, or who have relapsed after treatment, should be diagnosed and treated promptly.
2 There is a history of mucus and diarrhea, but the sudden increase in weight of the symptoms, and the change in the number of bowel movements and the nature of bowel movements should be reviewed again.
3 Constipation and diarrhea appear alternately without obvious cause. If there is no improvement in short-term treatment, if there is no abnormality in the stomach through the sputum fluoroscopy, the patient should go to the hospital for a rectal examination.
4 Defecation is laborious, and the discharged stool has an indentation, which is a trough-like flat strip, a thin strip, etc., and must be used for digital rectal examination. Any of the above four conditions should go to the hospital for inspection. Where conditions permit, it is best to have a surgical or anorectal examination.
Second, the symptoms of the middle and late
The clinical features of early rectal cancer are mainly changes in blood in the stool and defecation. When the cancer is confined to the rectal mucosa, blood in the stool is the only early symptom, accounting for 85%. Unfortunately, it is often not taken seriously by patients. At that time, anal finger examination, more can touch the mass, in addition to the general common loss of appetite, weight loss, anemia and other systemic symptoms in the middle and late stage of rectal cancer, there are more frequent bowel movements, incomplete defecation, frequent intentions, urgency and other cancers Local irritation. Increased cancer can cause intestinal stenosis, signs of intestinal obstruction.
Rectal cancer often invades surrounding tissues and organs, such as the bladder and prostate, causing frequent urination, urgency, and dysuria. Invading the anterior tibial nerve plexus, appendix and lumbar pain. Rectal cancer can also be transferred to the liver from afar, causing hepatomegaly, ascites, jaundice, and even dyscrasia.
Rectal cancer is easily misdiagnosed. When the number of stools in the early stage increases, mucus and pus in the stool, it is easy to be misdiagnosed as diseases such as dysentery, enteritis or hemorrhoids, thus losing the opportunity for early treatment. Therefore, when adults have abnormal bowel movements, they should be vigilant and undergo a proctoscopy or sigmoidoscopy if necessary.
Examine
Colorectal cancer examination
Auxiliary inspection
Blood routine shows small cell anemia, and erythrocyte sedimentation rate increases. The fecal occult blood test continued to be positive. The X-ray showed a filling defect of the tincture, the intestinal wall of the lesion was stiff, the peristalsis was weakened or disappeared, the colonic pocket was irregular, and the intestine was narrow or dilated. Colonoscopy can identify the nature of the lesion, size, and even the early detection of early lesions. In addition, serum carcinoembryonic antigen (CEA), B-ultrasound, abdominal CT examination is also helpful for diagnosis.
Diagnosis
Diagnosis and diagnosis of colorectal cancer
Differential diagnosis
It should be differentiated from inflammatory bowel disease, intestinal tuberculosis, and colon polyposis. Colon polyposis: Polypoid lesions that protrude from the surface of the mucosa to the intestine are called polyps before the pathological properties are determined. According to the pathology, adenomatous polyps (including papillary adenomas) are most common, inflammatory. Polyps, intestinal mucosa by long-term inflammation-stimulated hyperplasia, hamartoma-type polyps, other, such as mucosal hypertrophy to form hyperplastic polyps, lymphoid tissue hyperplasia, carcinoid and other diseases. Clinically, the polyps can be single or multiple, and the colorectal polyps are more common and the symptoms are more obvious. Polyposis can be treated according to different methods such as Chinese and Western medicine, colonoscopy, laser, freezing, ligation and transabdominal or transanal.
