Colon cancer is a common malignant tumor of the digestive tract that occurs in the colon. It occurs at the junction of the rectum and the sigmoid colon. The incidence rate is highest in the 40- to 50-year-old age group, and the ratio between males and females is 2 to 3:1. The incidence accounted for the third place in the gastrointestinal cancer. Colon cancer is mainly adenocarcinoma, mucinous adenocarcinoma, and undifferentiated carcinoma. The general morphology is polypoid, ulcerous and so on. Colon cancer can develop along the intestinal wall, and spread along the longitudinal diameter of the intestinal tract, or infiltrate deep into the intestinal wall. In addition to lymphatic vessels, blood flow, and local invasion, it can also be transplanted into the abdominal cavity or spread along the suture or incision surface. . Patients with chronic colitis, colon polyps, and male obesity are susceptible.

 

The cause of colon cancer

The incidence of colon cancer is mainly related to high-fat and low-fiber diets. The chronic inflammation of the colon causes a higher incidence of bowel cancer than in the general population. In patients with colon polyps, the incidence of colon cancer is five times that of colon polyps. Familial multiple intestinal polyposis, the incidence of cancer is higher. Genetic factors may also be involved in the pathogenesis of colon cancer.

Early symptoms of colon cancer:

1. Changes in stool habits: Right colon cancer manifests as early fecal thinning, pus, and increased frequency of defecation. Alternate diarrhea and constipation can also occur when cancer continues to increase and faeces pass through; left Semi-colonic cancer is often manifested as difficulty in defecation, and it continues to increase as the disease progresses. In addition, if the cancer is located in a low position, it can also cause poor bowel movements and a feeling of urgency.

2, gastrointestinal symptoms: manifested as abdominal distension, discomfort, or indigestion-like symptoms. In the right colon, most of them are abdominal pain or pain. It can be intermittent at first, then it can be persistent. It is often located in the right lower abdomen, much like chronic appendicitis. In the case of left colon cancer, the symptoms are sudden obstruction, abdominal cramps, bloating, and bowel movements. Hyperthyroidism, constipation and exhaust obstruction, or chronic obstructive symptoms such as discomfort in abdominal distension, paroxysmal abdominal pain, hyperactive bowel sounds, constipation, feces with blood, and mucus.

3, symptoms of poisoning: Early colon cancer symptoms also include the performance of patients often appear anemia, fever, fatigue, weight loss, edema and other manifestations, including especially anemia, weight loss.

4, abdominal mass: about 50% of patients can be found in the abdominal mass, the Department of cancer or with the omentum, the surrounding tissue infiltration and adhesion of the mass, hard, irregular body, some of the mass can be with the bowel The degree of activity, while advanced colon cancer due to cancer infiltration even more so that the mass can be fixed.

5, feces with blood or mucus: right colon cancer, the amount of bleeding is small and due to colonic motility make it fully mixed with the feces, resulting in visual observation is not easy to see, but the occult blood test is often positive; while the left colon cancer is its Bleeding and mucus are not mixed with feces, and about one-fourth of patients can see blood and mucus in the feces.

6. Intestinal obstruction performance: Incomplete or complete low intestinal obstruction symptoms, such as abdominal distention, abdominal pain (pain or cramps), constipation or closed. Physical examination can be seen in the abdomen, bowel, local tenderness, and can be heard and stubborn bowel sounds.

Colon cancer examination

1. Anal canal examination and rectal microscopy

Check for rectal polyps, rectal cancer, internal hemorrhoids, or other pathologies.

2. Sigmoidoscopy and colonoscopy

Microscopic examination can find cancer, observe its size, location and local infiltration range.

3. Abdominal plain film

For cases of acute intestinal obstruction, the colon above the obstruction site is inflated and swelled.

4. Barium enema

Visible cancerous parts of the intestinal wall stiffness, poor expansion, decreased or disappeared peristalsis, the shape of the colon bag is irregular or disappeared, the intestine stenosis, mucosal folds disorder, destruction or disappearance, filling defects. The dual contrast angiography of air ampoules is more helpful for the diagnosis of pedunculated tumors in the colon.

5. Carcinoembryonic antigen (CEA)

The diagnostic value of early-stage tumors is not large, and it is helpful for predicting prognosis and judging recurrence.

Differential diagnosis of colon cancer

1. Benign colon tumor

Long duration of illness, mild symptoms, X-ray findings of local filling defects, regular morphology, smooth surface, sharp edges, non-stenosis of the intestine, and complete colon pocket.

2. Colitis inflammatory disease

Refers to tuberculosis, schistosomiasis granulomatosis, ulcerative colitis, diarrhea and other intestinal inflammatory lesions, history has its own characteristics, stool microscopy can have its special findings, X-ray examination of the affected intestinal longer. Colonoscopy and histopathological examination are also different and can be further confirmed.

3. Others

Colon nevus: X-ray examination is a small segment of intestinal cavity stenosis, reversible.

Appendiceal abscess: There is a history of appendicitis, abdomen can be palpable and mass, but X-ray shows the mass outside the cecum.

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