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消化系统类癌41例的诊断和治疗[J]. 肿瘤防治研究, 2010, 37(10): 1170-1173. DOI: 10.3971/j.issn.1000-8578.2010.10.019
引用本文: 消化系统类癌41例的诊断和治疗[J]. 肿瘤防治研究, 2010, 37(10): 1170-1173. DOI: 10.3971/j.issn.1000-8578.2010.10.019
Diagnosis and Treatment of Digestive System Carcinoids:Clinical Analysis of 41 Cases[J]. Cancer Research on Prevention and Treatment, 2010, 37(10): 1170-1173. DOI: 10.3971/j.issn.1000-8578.2010.10.019
Citation: Diagnosis and Treatment of Digestive System Carcinoids:Clinical Analysis of 41 Cases[J]. Cancer Research on Prevention and Treatment, 2010, 37(10): 1170-1173. DOI: 10.3971/j.issn.1000-8578.2010.10.019

消化系统类癌41例的诊断和治疗

Diagnosis and Treatment of Digestive System Carcinoids:Clinical Analysis of 41 Cases

  • 摘要: 目的 探讨消化系统类癌的早期诊断及治疗。方法 回顾分析广西医科大学第一附属医院1977年12月—2007年10月收治的消化系统类癌41例的诊治经过。按类癌浸润深度分黏膜及黏膜下层、肌层、全层三组;按类癌直径大小分三组,用SPSS13.0软件包进行统计学分析,探讨类癌浸润、转移与年龄、病程、肿瘤直径大小的关系。结果 本组直肠多见有20例(48.8%),其次为胃6例(14.6%),胰腺4例(9.8%),阑尾3例(7.3%),十二指肠、结肠各2例,食管、肛管、肝、后腹腔各1例。临床表现缺乏特异性,以腹痛、消化道出血、腹泻为主要表现。有远处及淋巴结转移共9例。行胃肠镜检查确诊18例;CT诊断2例;MRI诊断1例;B型超声引导穿刺诊断1例,手术探查确诊19例。类癌直径大小在浸润黏膜及黏膜下层组与肌层组间差异无统计学意义(P>0.05),浸润全层组与浸润黏膜及黏膜下层组、浸润全层组与浸润肌层组间差异均有统计学意义(P<0.05);类癌转移在浸润黏膜及黏膜下层组与肌层组间差异无统计学意义(P>0.05),浸润全层组与浸润黏膜及黏膜下层组、肌层组间差异均有统计学意义(P<0.05)。随着类癌直径的增大,转移发生率增高。治疗:内镜下肿瘤黏膜下切除1例,手术切除37例,拒绝治疗3例。结论 对消化系统类癌的诊断,临床表现是主要指征,对直肠、肛管的类癌行直肠指诊尤为必要;内镜检查和手术探查是确诊的主要手段。对消化系类癌的治疗,首选手术切除,内镜下治疗是一种微创的新方法。

     

    Abstract: Objective To investigate the early diagnosis and treatment of digestive tract carcinoids. Methods Clinical features of 41 cases with digestive system carcinoids in the first affiliated hospital of Guangxi Medical University from December 1977 to October 2007 were analyzed retrospectively. According to depth of invasion, carcinoid was divided into three groups of mucosa and submucosum, muscular and beyond muscularis propria. According to the diameter of tumor, carcinoid also was divided into three groups. The relationships of depth and metastatisis of carcinoid with age, duration of diseases, diameter were analyzed by SPSS13.0. Results The tumors were located at the rectum in 20,stomach in 6 cases,pancreas in 4, appendix in 3, duodenum and colon in 2, esophagus, as well as anal canal, liver and retroperitoneal abdomen in 1. Although without special clinical manifestation, stomachache,hemorrhage of digestive tract and diarrhea were common clinical symptoms. Out of the 41 cases, distant or lymph node metastasis occured in 9 cases.Eighteen cases were diagnosed by endoscope, 2 by CT,1 by MRI, 1 by type-B ultrasonic guided puncture, and 19 by operations. There was no significant difference in diameter of carcinoid between mucosa and strata submucosum and muscular layer(P>0.05),there was significant difference among full-thickness and mucosa and strata submucosum,muscular layer(P<0.05).There was no significant difference between metastasis of carcinoid and depth of invasion,(P>0.05). there was significant difference among full-thickness and mucosa and strata submucosum,muscular layer(P<0.05).Metastasis possibility increment along with the aggrandizement of the diameter of carcinoid.Treatment:endoscopic mucosal resection (EMR)in 1 case, surgical resection in 37 cases,abandon in 3. Conclusion Clinical manifestation is the main attestation of the diagnosis.Anorectal touch is necessary for the rectum and anal canal carcinoid tumor. Endoscope and operations research are the main means of diagnosis. Surgical resection is preferred in treating carcinoid tumor. Edoscopic mucosal resection is a new microtrauma way.

     

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