CAJ | 학술논문

目的探讨直肠类癌的临床病理学特点及治疗方法.方法回顾性分析38例直肠类癌的临床病理资料.结果 38例均为典型性类癌,均位于距肛门10 cm以内.内镜下多表现为典型的黏膜下肿物,色黄、质硬或韧,活动度差.所有病例神经内分泌分化标记物染色阳性.直径≤2 cm者34例,其中30例位于黏膜内,4例侵犯黏膜下层,内镜下行黏膜切除术治愈;4例直径>2 cm,均侵犯肌层,行直肠癌根治术.肿瘤≤2 cm者Ki-67阳性表达率<3%或阴性.34例获随访,均存活.结论直肠类癌明确诊断依赖于组织病理学观察及免疫组化.直肠类癌生物学行为低度恶性,一般不侵犯肌层,也很少转移,多数病例可在内镜下行黏膜切除术治愈.
목적 탐토직장유암적림상병이학특점급치료방법.방법 회고성분석38례직장유암적림상병리자료.결과 38례균위전형성유암,균위우거항문10 cm이내.내경하다표현위전형적점막하종물,색황、질경혹인,활동도차.소유병례신경내분비분화표기물염색양성.직경≤2 cm자34례,기중30례위우점막내,4례침범점막하층,내경하행점막절제술치유;4례직경>2 cm,균침범기층,행직장암근치술.종류≤2 cm자Ki-67양성표체솔<3%혹음성.34례획수방,균존활.결론 직장유암명학진단의뢰우조직병이학관찰급면역조화.직장유암생물학행위저도악성,일반불침범기층,야흔소전이,다수병례가재내경하행점막절제술치유.
Objective To investigate the clinical and pathological characteristics of carcinoid tumor in rectum and its treatment. Methods The clinical and pathological data of 38 rectal carcinoid patients from Wuhan Center Hospital and Wuhan the Eighth Hospital from January 2005 to December 2009 and reviewed were analyzed retrospectively. Results All 38 cases were typical carcinoid, located in the rectum within 10 centimeters to the lower border of the anal canal.The classic characters were submuscosal tumor with yellow color and rigid or tough texture and always were lack of mobility. Carcinoid tumor of rectum often expressed markers of neuroendocrine differentiation on immunohistochemical staining.Among 38 cases, 34 cases were less than or equal to 2.0 cm in diameter and located in lamina propria (n=30) or invased submucosal layer (n=4), these patients were cured by endoscopic mucosal resection (EMR).Four cases were larger than 2.0 cm in diameter with muscularis externa invasion, treated by curative resection.All tumors <2.0 cm in diameter had a very lower Ki-67 labeling index (<3% ).34 patients survived at the latest follow-up. Conclusions The diagnosis of rectal carcinoid relies on histopathology and immunohistochemistry. The behavior of the rectal carcinoid shows low degree of malignant potentia. They rarely invade the muscularis externa or metastases. Most of them can be cured by endoscopic mucosal resection(EMR).