摘要
背景:直肠类癌属于神经内分泌肿瘤,临床上较少见。目前对直径1~2 cm的直肠类癌的治疗方式尚存在争议。目的:检测Ki-67在直肠类癌中的表达水平,探讨直肠类癌内镜切除治疗的疗效和安全性。方法:回顾性收集重庆三峡中心医院和武汉同济医院2008年1月至2013年12月期间确诊为直肠类癌,肿瘤直径<1.5 cm、行内镜黏膜切除术的患者83例,分析其病例资料,并以免疫组化方法检测肿瘤组织Ki-67表达。结果:术前内镜超声检查显示83例患者肿瘤均位于黏膜层或黏膜下层,无固有肌层浸润或转移,术后平均随访38个月,无一例患者复发或转移。所有患者肿瘤组织Ki-67均呈低表达(0.84%±0.67%),肿瘤直径<1.0 cm与1.0~1.5 cm组间性别、年龄、肿瘤部位、Ki-67表达水平差异无统计学意义(P>0.05)。以Ki-67指数均值0.84%为临界值分组,两组间各项临床病理参数差异亦无统计学意义(P>0.05)。结论:本组直径<1.5 cm的直肠类癌Ki-67均呈低表达,提示肿瘤细胞增殖不活跃。对于直径<1.5 cm、无固有肌层浸润或转移、Ki-67低表达的直肠类癌,内镜局部切除治疗安全、有效。
Background: Rectal carcinoid is a rarely seen neuroendocrine tumor. Till now,there is controversial for the treatment modalities of rectal carcinoids with diameter between 1-2 cm. Aims: To study the expression of Ki-67 in rectal carcinoids and the efficacy and safety of endoscopic resection. Methods: A total of 83 rectal carcinoid patients with tumor diameter less than 1. 5 cm were enrolled. All patients were pathologically diagnosed and underwent endoscopic mucosal resection from Jan. 2008 to Dec. 2013 at Chongqing Three Gorges Central Hospital and Wuhan Tongji Hospital. The medical records were retrospectively reviewed and expression of Ki-67 in tumor tissue was assessed by immunohistochemistry. Results: All patients underwent preoperative endoscopic ultrasonography. Tumors were limited to mucosa or submucosa, and no muscularis propria involvement or metastasis was seen. The mean follow-up duration was 38 months,and no recurrence or metastasis occurred. Ki-67 was lowly expressed in all rectal carcinoids( 0. 84% ± 0. 67%). When tumors were grouped by size,no significant differences in gender,age,tumor site and Ki-67 expression level were seen between < 1. 0 cm group and 1. 0-1. 5 cm group( P > 0. 05). Furthermore,when tumors were grouped by a cutoff value of mean Ki-67 index0. 84%,differences in clinicopathological parameters between the two groups were not significant either( P > 0. 05).Conclusions: Ki-67 is lowly expressed in rectal carcinoids less than 1. 5 cm in diameter enrolled in this study,which denoted an inactive proliferation. For rectal carcinoids with diameter less than 1. 5 cm,with low Ki-67 expression and without muscularis propria involvement and metastasis,local endoscopic excision is an effective and safe treatment modality.
出处
《胃肠病学》
2014年第11期682-684,共3页
Chinese Journal of Gastroenterology
关键词
直肠类癌
免疫组织化学
KI-67抗原
内镜切除
预后
Rectal Carcinoids
Immunohistochemistry
Ki-67 Antigen
Endoscopic Resection
Prognosis
