最后审阅: 19 九月 2021
最后更新: 29 三月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 年龄增长
  • 直肠出血
  • 大便习惯改变
  • 直肠肿块
  • 阳性家族史
  • 腹部肿块

其他诊断因素

  • 贫血
  • 男性
  • 腹痛
  • 体重减轻和厌食
  • 腹胀
  • 可触及的淋巴结

危险因素

  • 年龄增长
  • 结肠腺瘤样息肉病突变
  • Lynch 综合征(遗传性非息肉病性结直肠癌)
  • MUTYH/MYH 相关性息肉病
  • 错构性息肉病综合征
  • 炎症性肠病
  • 肥胖
  • 肢端肥大症
  • 缺乏体育锻炼
  • 缺乏膳食纤维

诊断性检查

首要检查

  • 全血细胞计数
  • 肝脏生化指标
  • 肾功能
  • 结肠镜检查
  • CT 结肠成像术
  • 双对比钡灌肠
  • 胸部、腹部和盆腔 CT 扫描

需考虑的检查

  • 盆腔 MRI 直肠癌检查方案
  • 经直肠超声内镜检查 (transrectal endoscopic ultrasound, TRUS)
  • 活检
  • 癌胚抗原 (carcinoembryonic antigen, CEA)
  • PET 扫描

新兴检查

  • 先进的光学影像技术

治疗流程

撰稿人

作者

David E. Stein, MD, FACS, FASCRS

Regional Chief of Surgery

MedStar Health

Baltimore

MD

利益声明

DES declares that he has no competing interests.

David M. Lisle, MD

Associate Program Director

Department of Surgery

MedStar Franklin Square Medical Center

Baltimore

MD

利益声明

DML declares that he has no competing interests.

Pallavi P. Kumar, MD

Co-Director of Medical Oncology

Director of Immuno-Oncology

MedStar Franklin Square Medical Center

Harry and Jeanette Weinberg Cancer Institute

Baltimore

MD

利益声明

PPK declares that she has no competing interests.

Kamila A. Nowak-Choi, MD

Department of Radiation Oncology

MedStar Franklin Square Medical Center

Baltimore

MD

利益声明

KANC declares that she has no competing interests.

鸣谢

Dr David E. Stein, Dr David M Lisle, Dr Pallavi P Kumarm and Dr Kamila A Nowak-Choi would like to gratefully acknowledge Dr Juan L. Poggio, Dr Jascha Rubin, Dr Najjia Mahmoud, Dr Emily Carter Paulson, Dr Gary Atkin, Dr Anne Ballinger, Dr Mark O'Hara, Dr Mark Harrison, and Dr Robert Glynne-Jones, previous contributors to this topic.

利益声明

JLP, JR, NM, ECP, MOH, GA, and AB declare that they have no competing interests. MH is the chair of the Mount Vernon Upper GI Tumour Site Specific Group and a member of the National Cancer Research Institute anal, rectal, and advanced colorectal groups. He has also received honoraria for speaking and has been supported to attend international meetings in GI cancer from Roche. He has also received research funding from Pfizer for a trial in rectal cancer. RGJ is the chief medical adviser to the charity Bowel Cancer UK. He has received honoraria for lectures from Roche, Sanofi, and Pfizer. He has received funding for the EXTRA study, involving capecitabine and radiotherapy in anal cancer, published in the International Journal of Radiation Biology Physics. RGJ has also received funding and free cetuximab for an ongoing phase I/II study integrating cetuximab into chemoradiation in rectal cancer, and has an agreement from Roche to supply bevacizumab for 3 months to 60 patients in one randomised phase II study as neoadjuvant chemotherapy in rectal cancer (BACCHUS). He has also been supported by Roche to attend international meetings in GI cancer.

同行评议者

Susan Clark, BChir, MB

Consultant Colorectal Surgeon

St Mark's Hospital and Academic Institute

Northwick Park

Middlesex

UK

利益声明

SC declares that she has no competing interests.

Steven Wexner, MD, FACS, FRCS, FRCS Ed, FASCRS, FAC

Chief of Staff

Chairman

Department of Colorectal Surgery

Cleveland Clinic

Weston

FL

利益声明

SW declares that he has no competing interests.

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