早期大肠癌临床、病理特点及黏膜凹窝分型分析  

Retrospective analysis of clinical symptom,pathology and pit pattern on early colorectal cancer

作　　者：吴巍[1] 顾掌生[1] 吴云林[2] 钟捷[2] 梁金安[3] 

机构地区：[1]浙江省湖州市中心医院消化科,湖州313000 [2]上海市第二医科大学附属瑞金医院消化科 [3]广东省高州市人民医院消化科

出　　处：《胃肠病学和肝病学杂志》2003年第3期270-272,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的　探讨早期大肠癌的诊断和治疗方法。方法　经手术证实的早期大肠癌 3 3例 ,对临床症状、肿瘤的部位、大小、大体形态、黏膜凹窝分型、治疗方法、肿瘤的浸润深度及随访结果进行分析。结果　临床症状以便血为多 ,占 60 6% (2 0 / 3 3 ) ,肛检阳性率高 ,占 60 6% (2 0 / 3 3 ) ,肿瘤位于直肠及右半结肠多 ,占 90 9% (3 0 / 3 3 ) ,形态以隆起型为主 ,其中亚有蒂型占 5 7 6% (19/ 3 3 ) ,直径 1。 6cm的占 90 9% (3 0 / 3 3 ) ,pitpanern分型IV十V、V型占 80 % (8/ 10 ) ,肿瘤局部切除加内镜下治疗占 3 6 4% (12 / 3 3 ) ,手术切除占63 6% (2l/ 3 3 ) ,经 7个月～ 5年 6个月随访 ,均无复发。结论　通过临床症状分析、变焦大肠镜下黏膜凹窝分型有助于提高早期大肠癌的检出率 ,尤其是平坦及凹陷型病变的检出。早期大肠癌可积极开展镜下治疗 ,包括内镜、腹腔镜下治疗。Objective To study the diagnostic and treatment methods of Early Colorectal Cancer(ECC) Methods Through 33 cases of treated ECC retrospective analysis of clinical symptom,pathological documents,size and location and macroscopic appearance of the tumor,pit pattern,invasional depth of cancer were carried out Results The most frequent sympton in ECC was colorectorrhagia (20/33,60 6%);the most frequent location of the tumors were right colon and rectum(30/33,90 9%);the most frequent lesion subpedunculated type of type I(Isp)(19/33,57 6%) The most frequent size of tumor ranged from 1to 6 cm(30/33,90 9%),the most frequent pattern in pit pattern classification were Ⅳ+Ⅴ or Ⅴ(8/10,80%) ECC were treated by a divers mothods,such as local excision under endoscope(12/33,36 4%) and surgical operation(21/33,63 6%) All cases followed from 7 months to 5 years and 6 months failed to show any recurrence Conclusions The clincal symptoms,the pit pattern analysis under magnifying colonoscope were the useful methods to diagnose ECC,especially to diagnose flat or depressed nonpolypoid ECC ECC may be treated more actively by local excision under endoscope It is no difference to extend lives whether post chemotherepy will be done or not

关 键 词：早期大肠癌 临床病理特点 黏膜凹窝分型 内窥镜检查 随访 

分 类 号：R735.34[医药卫生—肿瘤]