High-risk groups for colon cancer include.
◇People with intestinal symptoms such as blood in stool, frequent stools, stools with mucus and abdominal pain
◇Middle-aged and elderly people in areas with high incidence of colorectal cancer
◇Patients with colorectal adenoma
◇Patients with a history of colorectal cancer
◇Family members of colorectal cancer patients
◇Patients with familial colorectal adenomatosis
◇Patients with ulcerative colitis
◇Patients with Crohn’s disease
◇Patients with a history of pelvic radiation therapy
Staging of colon cancer
Colon cancer staging includes Dukes staging and TNM staging.
Since the Dukes staging of colon cancer proposed in 1932 is simple and easy to implement and has certain prognostic guidance, it is still used.
Dukes staging of colon cancer
Dukes stage A: the tumor is confined to the intestinal wall
Dukes stage B: tumor invades outside the intestinal wall
Dukes stage C: with regional lymph node metastasis, regardless of the depth of invasion.
TNM staging of colon cancer
The TNM staging system proposed by the American Joint Cancer Society (AJCC, 2009 7th edition) provides better guidance for the prognosis of colon cancer.
T-Primary tumor staging
Tx Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis carcinoma in situ: intraepithelial or intramucosal lamina propria
T1 Tumor invades submucosal layer
T2 Tumor invades intrinsic muscular layer
T3 Tumor invading subplasma or paramecium without peritoneal covering
T4 Tumor penetrates the visceral peritoneum and/or directly invades other organs or structures
T4a Tumor penetrates the surface of the visceral peritoneum
T4b Tumor directly invades other organs or structures
N-Regional lymph nodes
Nx Regional lymph nodes cannot be evaluated
N0 No regional lymph node metastasis
N1 1-3 regional lymph node metastases
-N1a 1 regional lymph node metastasis
-N1b 2-3 regional lymph node metastases
-N1c No regional lymph node metastases, but single (or multiple) cancer nodes (satellite foci) in subplasmic or pararectal tissue without peritoneal cover
N2 ≥4 regional lymph node metastases
-N2a 4-6 regional lymph node metastases
-N2b ≥7 regional lymph node metastases
M – distant metastasis
M0 No distant metastasis
M1 with distant metastases
-M1a Metastasis to a single organ or site
-M1b Metastases to multiple organs or sites or peritoneal metastases