胃肠道类癌72例内镜下诊治与预后分析  

The endoscopic diagnosis, treatment and prognosis analysis of 72 cases of gastrointestinal carcinoid tumors

作　　者：赵丹瑜[1] 陈星[1] 康艳[1] 

机构地区：[1]山西省人民医院消化内镜中心,太原030012

出　　处：《中华消化杂志》2012年第2期85-89,共5页Chinese Journal of Digestion

摘　　要：目的探讨胃肠道类癌的内镜下诊断、治疗、病理特点及预后情况。方法回顾性分析山西省人民医院2004年7月至2010年7月内镜下诊治，经病理确诊并随访的胃肠道类癌72例。总结其常规内镜诊断、内镜下超声诊断、病理特点、治疗情况及预后分析。结果共确诊并成功随访上消化道类癌26例，下消化道类癌46例，单发65例，多发7例，肿瘤大多为偏黄色广基扁平、丘状或隆起质硬结节，活动度不明显。超声内镜多表现为位于黏膜下层不均匀的低回声结节。采用内镜下黏膜切除术（EMR）或内镜下黏膜剥离术（ESD）成功治疗单发类癌51例，治愈率96．2％（51／53）；EMR治愈多发类癌3例，治愈率3／7，术后随访肿瘤无复发。结论内镜检查是发现早期类癌的重要手段，内镜下超声探查可以进一步明确病变来源及层次，并可为内镜下治疗提供依据。EMR及ESD为根治早期类癌的首选方法。Objective To explore endoscopic diagnosis, treatment, pathological features and prognosis of gastrointestinal carcinoid tumors. ＂Methods Retrospective analysis of 72 cases of gastrointestinal carcinoid tumors which were endoscopically diagnosed, treated, pathologically confirmed and followed up from July 2004 to July 2010 in Shanxi Provincial People＇ s Hospital. Common endoscopic diagnosis, endoscopic ultrasound （EUS） diagnosis, pathological features, treatment and prognosis were summarized. Results Twenty six cases of upper gastrointestinal carcinoid tumors and 46 cases of lower gastrointestinal carcinoid tumors were diagnosed and followed up. A total of 65 cases were single carcinoid and 7 were multiple carciniods. Tumors were mostly yellowish hard nodules with limited range of movement. EUS showed uneven hypoechoic nodules in the submucosal layer. Fifty-one cases of single carcinoid tumor were successfully treated with endoscopic mucosal resection （EMR） or endoscopic submucosal dissection （ESD） and the cure rate was 96.2% （51/53）. Three cases of multiple carciniods were cured with EMR and the cure rate was 3/7. There was no tumor recurrence after treatment during follow-up. Conclusions Endoscopy examination is an important way to detect early carcinoid tumors. Endoscopic ultrasound probe can further clarify source and level of the lesion, and provide the basis for the endoscopic therapy. EMR and ESD are the preferred radical treatment for early carcinoid tumors.

关 键 词：类癌瘤 胃肠肿瘤 内窥镜检查 胃黏膜 肠黏膜 预后 

分 类 号：R735[医药卫生—肿瘤]