CAJ | 학술논문

目的分析和探讨直肠类癌的临床表现、病理特点、治疗方法及预后.方法收集华中科技大学同济医学院附属协和医院等8家医院从1997年1月至2010年1月期间经病理检查确诊的直肠类癌病例69例,分析其临床表现、病理特点、治疗方法及预后.结果 69例直肠类癌患者中男性36例,女性33例,平均年龄49.3岁,常见症状为便血、腹痛、便秘、腹泻、腹胀.病变距肛门8cm及以内者55例,其余患者病变距肛门8 cm以上.典型类癌66例,非典型类癌3例.有40例患者行免疫组织化学检查,常用免疫组织化学指标为突触素(Syn)、嗜铬素A(CgA)、神经元特异性烯醇化酶(NSE),其阳性率分别为90％(36/40)、75％(30/40)、82.5％(33/40).24例患者行单纯内镜治疗,44例行手术治疗,1例因患者拒绝手术而行相关支持对症治疗.结论直肠类癌临床症状无特异性,以典型类癌多见,对病变局限于黏膜及黏膜下层者可考虑行内镜下治疗.
목적 분석화탐토직장유암적림상표현、병리특점、치료방법급예후.방법 수집화중과기대학동제의학원부속협화의원등8가의원종1997년1월지2010년1월기간경병리검사학진적직장유암병례69례,분석기림상표현、병리특점、치료방법급예후.결과 69례직장유암환자중남성36례,녀성33례,평균년령49.3세,상견증상위편혈、복통、편비、복사、복창.병변거항문8cm급이내자55례,기여환자병변거항문8 cm이상.전형유암66례,비전형유암3례.유40례환자행면역조직화학검사,상용면역조직화학지표위돌촉소(Syn)、기락소A(CgA)、신경원특이성희순화매(NSE),기양성솔분별위90％(36/40)、75％(30/40)、82.5％(33/40).24례환자행단순내경치료,44례행수술치료,1례인환자거절수술이행상관지지대증치료.결론 직장유암림상증상무특이성,이전형유암다견,대병변국한우점막급점막하층자가고필행내경하치료.
Objective To analyze and explore the clinical features,pathological characters,treatment and prognosis of rectum carcinoid.Methods From January 1997 to January 2010,69 pathologically diagnosed rectum carcinoid cases were collected from Union Hospital of Tongji Medical College,Huazhong University of Science and Technology and other 7 hospitals.The clinical features,pathological characters,treatment and prognosis were analyzed. Results Of 69 rectum carconid cases,there were 36 males and 33 females.The average age was (49.3±12.9) years.The common symptom were hemotochezia,abdominal pain,constipation,diarrhoea and abdominal distension.There were 55 cases with lesions from the anus less than 8 cm and in other patients,lesions from the anus were all more than 8 cm.66 cases were typical carcinoid,3 cases were atypical carcinoid.40 cases underwent the immunohistochemical staining.The common markers for immunohistochemical staining were Syn,CgA and NSE,the positive percentage were 90％ (36/40),75％ (30/40) and 82.5％(33/40) respectively.A total of 24 patients received endoscopic therapy,44 patients had surgery,1 patient who refused surgery received only life support and symptomatic treatment.Conclusion No specific clinical symptoms of rectum carcinoid,and most were typical carcinoid.Lesions confined to mucosa and submucosa could be considered the endoscopic therapy.