腹膜后神经内分泌癌五例临床诊治分析  

Diagnosis and treatment analysis of 5 cases with retroperitoneal neuroendocrine carcinoma

作　　者：黄帅[1] 袁兴华[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院腹部外科,北京100021

出　　处：《肿瘤研究与临床》2012年第9期607-609,共3页Cancer Research and Clinic

摘　　要：目的探讨原发性腹膜后神经内分泌癌（NEC）的临床特点以及诊治经验。方法对2000年1月至2012年1月收治的5例原发腹膜后NEC患者的临床资料进行回顾性分析。结果5例患者中男4例，女1例，中位年龄53岁。3例患者以腹部不适伴疼痛为初始症状，2例患者术前无任何不适主诉和异常体征。术前均行B型超声及CT等影像学检查，1例误诊为胰头占位，1例误诊为胰岛细胞瘤且与周围组织关系密切，初始行动脉化疗栓塞2次。5例患者的血清学标志物癌胚抗原（CEA）及血清糖类抗原199（CA199）、CA242均正常；均行手术治疗，2例行根治性腹膜后肿物切除术，1例二次手术后行姑息性肿瘤切除术，2例术中探查肿瘤不可切除，行胃一空肠及空肠一空肠吻合术。2例患者明确病理分型为小细胞NEC，3例术中取少许组织行活组织检查，证实为NEC。5例患者均获得术后随访，术后3年生存2例。结论腹膜后NEC临床罕见，肿瘤侵袭性强且恶性程度高，根治性手术切除率低，以手术为主的综合治疗仍是目前临床上的首选治疗手段。此类患者的早期诊断仍有待于进一步提高。Objective To analyze the clinical features and diagnostic experiences of retroperitoneal neuroendocrine carcinoma （NEC）. Methods Clinical data of primary retroperitoneal NEC from January 2000 to January 2012 were retrospectively collected and analyzed. Results Five candidates were included 4 male and 1 female. The median age was 53 years old. 3 cases initially suffered from abdominal pain and radiative back pain, 2 cases were confirmed by normal physical check. The CT scan and B type ultrasound were performed among all patients, 1 case was diagnosed as pancreas head neoplasm, 1 case pancreas insulinoma, which was closely associated with other tissues and the intervational therapy was performed twice preoperatively. All 5 cases were selected surgery as the main treatment, 2 cases performed radical tumor resection, 3 cases received bypass operation. 2 cases were 3 years survival. Conclusion Retroperitoneal NEC is a rare carcinoma, characterized by seriously invasion and high malignant degree. Surgery still remains the mainstay of selections, early diagnosis can significantly improve NEC patients＂ overall survival rate. But the early diagnosis rate of this rare kind of patients still need to be improved.

关 键 词：腹膜后肿瘤 癌 神经内分泌 治疗 

分 类 号：R735.4[医药卫生—肿瘤]