直肠类癌33例的诊治分析  

The diagnosis and treatment of rectal carcinoid: a report of 33 cases

作　　者：邹鸿志[1] 郁宝铭[1] 李东华[1] 赵任[1] 孙骥远[1] 王志伟[2] 

机构地区：[1]上海第二医科大学附属瑞金医院普外科,200025 [2]上海第二医科大学细胞生物学实验室

出　　处：《中华普通外科杂志》2001年第10期581-583,共3页Chinese Journal of General Surgery

摘　　要：目的　探讨直肠类癌的临床、病理及预后影响因素。方法　回顾性分析 3 3例直肠类癌的临床病理资料 ,并进行随访 ,将其按直径大小和肌层是否有浸润分别分组 ,比较各组手术治疗效果及其生存率的区别。结果　直肠类癌以大便习惯改变 ( 17/ 3 3 ,5 2 % )、便血 ( 14 / 3 3 ,4 2 % )和体检发现直肠肿块 ( 14 / 3 3 ,4 2 % )为主要临床表现。直肠类癌一般发现较早 ,肿瘤直径 >2cm或浸润肌层者分别占 12 % ( 4 / 3 3 )。电灼术、局切术和扩大局切术共占 79% ( 2 6/ 3 3 ) ,根治性手术仅占 18% ( 6/ 3 3 )。所有病例 (n =2 9)总的 10年生存率为 84 % ,肿瘤直径 <2cm组 (n =2 6) 10年生存率为 94 % ,而 >2cm组 (n =3 )无 1例活过 5年 ,两者差别非常显著 (P =1 0× 10 -9) ;未浸润肌层者 (n =2 5 ) 10年生存率为94 % ,而浸润肌层者 (n =4 )仅 1例活过 5年 ,两者差异非常显著 (P =1 2× 10 -5)。结论　直肠类癌一般能早期发现 ,局部切除效果好。Objective To study the clinical and pathological features of rectal carcinoid and factors influencing the prognosis.Methods Data of 33 rectal carcinoid patients were analyzed retrospectively. 29 patients were followed up postoperatively. Primary tumors were classified by size (<2*!cm and >2*!cm) and muscularis invasion respectively.Results The main symptoms were changes in bowel habits(17/33,52%) and hematochezia (14/33, 42%), or rectal mass (14/33,42%), asymptomatic patients were detected during a survey.Only 4(12%) patients had tumors larger than 2 cm and tumors invading muscularis.The 10 year survival rate was 84% for all patients( n =29), and 94% for those with tumors <2*!cm ( n =26). All patients with tumors >2*!cm( n =3) died in 5 years( P = 1 0×10 -9 ) and only one out of the 4 with muscularis invasion lived longer than 5 years( P =1 2×10 -5 ).Conclusions Most rectum carcinoid are at early stage suitable for local excision.

关 键 词：直肠肿瘤 类癌瘤 外科手术 

分 类 号：R735.37[医药卫生—肿瘤]