摘要
目的:探讨直肠类癌的诊断、病理学特点、外科治疗方法的选择及预后因素。方法:对1995～2009年收治的11例直肠类癌临床病理资料进行回顾性分析。结果:11例术前均行直、乙状结肠镜检查并活检,其中5例术前确诊为直肠类癌。11例肿瘤距肛缘均≤8 cm。肿瘤直径<1 cm者3例,均无肌层浸润;1～2 cm者3例,1例有肌层浸润,2例无肌层浸润;>2 cm者5例,均有肌层浸润。免疫组织化学结果显示:11例神经元特异性烯醇化酶阳性,10例嗜铬粒蛋白A阳性,4例囊泡突触素阳性。局部切除术及电灼术共3例,根治性手术7例。术后随访7～192个月,2例死于肝转移,其余均存活,最长存活时间为192个月。结论:直肠指诊和直、乙状结肠镜检查是诊断直肠类癌最简单有效的手段。对可疑病变行活检时,除常规HE染色外,应加做免疫组织化学检查。手术切除是最佳的治疗方法。肿瘤大小及浸润深度是决定手术方式和预后的主要依据。
Objective：To study the diagnosis,pathological features,surgical therapy and prognosis of rectal carcinoid. Methods：Clinicopathologic data of 11 patients with rectal carcinoid were analyzed retrospectively. Results：The rectoromanoscopy and biopsy were taken in all patients.Tumor location were between the anal verge and 8 cm in 11 patients.Three patients with tumor 1 cm in diameter had no muscularis invasion;3 patients with tumors 1-2 cm,1 case had muscularis invasion,2 cases had no muscularis invasion;5 patients with tumors 2 cm had muscularis invasion.Immunohistochemistry study was done in all patients.Eleven cases were positive for neuron-specific enolase,10 cases were positive for chromogranias A,4 cases were positive for synaptophysin.Three patients were treated with local resection or fulguration,7 patients were freated with radical operation.These patients were followed-up 7-192 months with 2 patients died. Conclusions：The authors consider the digital examination of the rectum and rectoromanoscopy are important methods to diagnose rectal carcinoid preoperatively,in addition,for suspicious case,immunohistochemistry study should be made besides routine HE staining,The operative treatment is the best therapy to this kind of disease.The choice of operative mode and prognosis depend on the size of tumor and depth of invasion.
出处
《蚌埠医学院学报》
CAS
2012年第12期1489-1491,共3页
Journal of Bengbu Medical College
关键词
直肠肿瘤
类癌
外科手术
病理
rectal neoplasms
carcinoid tumor
surgical procedures
pathology
