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

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.