CAJ | 학술논문

目的：探讨Ⅲ型胃类癌的临床表现、内镜下特征、病理特点和治疗方法，以提高Ⅲ型胃类癌的早期诊断和治疗水平。方法根据Modlin等的分型标准，对2006年1月-2013年4月本院确诊的Ⅲ型胃类癌14例临床资料进行回顾性总结分析。结果本组Ⅲ型胃类癌患者以消化系统症状和肿瘤相关症状(出血或转移)为主要临床表现，内镜下表现为半球形或息肉样黏膜下肿物，孤立存在，表面常伴有充血、糜烂，触之质韧或硬，有滑动感，当病变累及肌层时不易推动。3例行内镜下治疗，2例内镜下治疗后再行外科手术治疗，3例行腹腔镜下胃部分切除治疗，4例行外科开腹胃部分切除治疗(其中1例术后辅以化疗)，1例发生肝转移采取化疗姑息治疗，1例死于类癌广泛转移。随访13例，平均随访时间11.7(3~79)个月。结论Ⅲ型胃类癌无特异临床表现，内镜检查及病理免疫组化是早期诊断的重要手段。早期正确判断胃类癌类型，有助于正确选择治疗方法，提高生存率。
목적：탐토Ⅲ형위유암적림상표현、내경하특정、병리특점화치료방법，이제고Ⅲ형위유암적조기진단화치료수평。방법근거Modlin등적분형표준，대2006년1월-2013년4월본원학진적Ⅲ형위유암14례림상자료진행회고성총결분석。결과본조Ⅲ형위유암환자이소화계통증상화종류상관증상(출혈혹전이)위주요림상표현，내경하표현위반구형혹식육양점막하종물，고립존재，표면상반유충혈、미란，촉지질인혹경，유활동감，당병변루급기층시불역추동。3례행내경하치료，2례내경하치료후재행외과수술치료，3례행복강경하위부분절제치료，4례행외과개복위부분절제치료(기중1례술후보이화료)，1례발생간전이채취화료고식치료，1례사우유암엄범전이。수방13례，평균수방시간11.7(3~79)개월。결론Ⅲ형위유암무특이림상표현，내경검사급병리면역조화시조기진단적중요수단。조기정학판단위유암류형，유조우정학선택치료방법，제고생존솔。
Objective To improve the early diagnosis and treatment of type 3 carcinoid by studying its clinical manifestations, endoscopic features, pathologic characteristics, and treatment modalities.Methods The clinical data about 14 patients with type 3 gastric carcinoid admitted to our hospital from January 2006 to April 2013 were retrospectively analyzed.Results The main clinical manifestations of the patients were gastrointestinal symptoms and tumor-related symptoms (bleeding or metastasis). Endoscopy showed solitary hemispherical or polypoid submucosal tumors with congestive or erosive surfaces, which were tough or hard and could be pushed. It was hard to move when the muscular layer was involved. Of the 14 patients, 3 underwent endoscopic resection, 2 received surgery after endoscopic resection, 3 underwent laparoscopic local resection, 4 received partial gastric excision (1 received chemotherapy after operation), and 1 received chemotherapy due to liver metastasis, 1 died of widespread metastasis of carcinoid. Thirteen patients were followed up for an average period of 11.7 months (3-79 months).Conclusion Since type 3 gastric carcinoid lacks of specific clinical manifestations, endoscopy and immunohistochemistry are the key methods for its early diagnosis which is essential to recognize the type of gastric carcinoid, to decide its treatment modalities, and improve the survival rate of its patients.