CAJ | 학술논문

目的探讨结直肠神经内分泌癌的临床诊治及预后.方法回顾性分析1995年1月至2010年1月间河南省肿瘤医院收治的39例结直肠神经内分泌癌患者的临床资料.结果 39例患者中男27例,女12例.所有病例均未出现内分泌紊乱的表现,术前有14例(35.9％)经病理学诊断为神经内分泌癌.22例患者行根治性手术,14例行姑息性切除术,3例仅行活检术.所有病例均予顺铂加依托泊苷的术后辅助化疗.36例切除的病灶中,27例(75.0％)有脉管浸润,29例(80.6％)有淋巴结转移；全组患者中有11例(28.2％)出现远处转移.病理分型:高分化型22例(56.4％),中间型9例(23.1％),小细胞型8例(20.5％).全组患者术后获得4～67个月的随访,1、3、5年生存率分别为48.2％、16.5％和6.8％.患者的生存状况与肿瘤的分期、脉管浸润和手术根治性有关(P＜0.05)；而与年龄、性别、肿瘤的大小和位置无关(P＞0.05).结论结直肠神经内分泌癌无特异性临床表现,恶性程度高,预后差,肿瘤分期、有无脉管浸润和能否根治切除是影响预后的重要因素.
목적 탐토결직장신경내분비암적림상진치급예후.방법 회고성분석1995년1월지2010년1월간하남성종류의원수치적39례결직장신경내분비암환자적림상자료.결과 39례환자중남27례,녀12례.소유병례균미출현내분비문란적표현,술전유14례(35.9％)경병이학진단위신경내분비암.22례환자행근치성수술,14례행고식성절제술,3례부행활검술.소유병례균여순박가의탁박감적술후보조화료.36례절제적병조중,27례(75.0％)유맥관침윤,29례(80.6％)유림파결전이；전조환자중유11례(28.2％)출현원처전이.병리분형:고분화형22례(56.4％),중간형9례(23.1％),소세포형8례(20.5％).전조환자술후획득4～67개월적수방,1、3、5년생존솔분별위48.2％、16.5％화6.8％.환자적생존상황여종류적분기、맥관침윤화수술근치성유관(P＜0.05)；이여년령、성별、종류적대소화위치무관(P＞0.05).결론 결직장신경내분비암무특이성림상표현,악성정도고,예후차,종류분기、유무맥관침윤화능부근치절제시영향예후적중요인소.
Objective To investigate the diagnosis,treatment and prognosis of colorectal neuroendocrine carcinoma.Methods Clinical data of 39 patients with colorectal neuroendocrine carcinoma from Jan 1995 to Jan 2010 were analyzed retrospectively and the related literatures were reviewed.Results There were 27 males and 12 females.No patients presented endocrinal dysfunction symptoms.Fourteen patients were diagnosed as neuroendocrine cancer by preoperative pathological examination.All the patients received postoperative adjuvant chemotherapy including cis-platinum and etoposide.Twenty-two patients underwent curative resection,while 14 underwent palliative resection and 3 underwent biopsy alone.Of the 36 surgical resection specimens,vascular invasion was found in 27 patients (75.0％) and regional lymph node metastasis was found in 29 patients (80.6％).Length of follow-up ranged from 4 to 67 months.The 1-year,3-year and 5-year survival rates were 48.2％,16.5％ and 6.8％,respectively.Statistically significant differences in survival were observed and associated with tumor staging,vascular invasion and surgery type (P＜0.05),but not related to gender,age,tumor location,or diameter (P＞0.05).Conclusions Clinical symptoms and signs of colorectal neuroendocrine carcinoma are nonspecific with poor prognosis.Tumor staging,vascular invasion and surgical type have potential impact on survival.