CAJ | 학술논문

背景与目的：直肠小细胞癌恶性程度高，易发生早期转移，临床上罕见，预后较差。本研究分析直肠小细胞癌的临床特点，并总结其临床诊断、治疗方法及预后。方法：回顾性分析2000年1月—2013年1月郑州大学附属肿瘤医院收治的经病理证实的16例直肠小细胞癌患者的临床资料。结果：16例患者中，男性9例，女性7例，中位年龄58.5岁；TNM分期Ⅱ期4例，Ⅲ期7例，Ⅳ期5例。10例行手术治疗，其中6例行根治性手术，4例行姑息性手术，术后6例接受单纯化疗，2例接受放化疗，2例未接受任何治疗。5例诊断时失去手术机会，其中3例仅行化疗，2例行放化疗。1例未行任何治疗。10例手术切除的病灶中，5例有脉管浸润，7例有局部淋巴结转移。全组患者获得7~65个月的随访。中位生存期15.4个月。6个月、1年、2年、3年和5年生存率分别为58.4%、46.2%、26.6%、13.1%和6.2%。患者的预后与肿瘤的分期、有无脉管浸润、有无淋巴结转移和手术根治程度有关(P<0.05)；而与年龄、性别和肿瘤的大小无关(P>0.05)。结论：直肠小细胞癌临床上罕见，其生物学行为与小细胞肺癌相似，病情进展迅速，预后较差，治疗方法以手术、放疗、化疗为主，总体疗效不佳。
배경여목적：직장소세포암악성정도고，역발생조기전이，림상상한견，예후교차。본연구분석직장소세포암적림상특점，병총결기림상진단、치료방법급예후。방법：회고성분석2000년1월—2013년1월정주대학부속종류의원수치적경병리증실적16례직장소세포암환자적림상자료。결과：16례환자중，남성9례，녀성7례，중위년령58.5세；TNM분기Ⅱ기4례，Ⅲ기7례，Ⅳ기5례。10례행수술치료，기중6례행근치성수술，4례행고식성수술，술후6례접수단순화료，2례접수방화료，2례미접수임하치료。5례진단시실거수술궤회，기중3례부행화료，2례행방화료。1례미행임하치료。10례수술절제적병조중，5례유맥관침윤，7례유국부림파결전이。전조환자획득7~65개월적수방。중위생존기15.4개월。6개월、1년、2년、3년화5년생존솔분별위58.4%、46.2%、26.6%、13.1%화6.2%。환자적예후여종류적분기、유무맥관침윤、유무림파결전이화수술근치정도유관(P<0.05)；이여년령、성별화종류적대소무관(P>0.05)。결론：직장소세포암림상상한견，기생물학행위여소세포폐암상사，병정진전신속，예후교차，치료방법이수술、방료、화료위주，총체료효불가。
Background and purpose:Rectal small cell carcinoma is high malignant tumor and prone to early metastasis. It is rare in the clinical and its prognosis is poor. The aim of this article was to analyze clinical characteristics and summarize the diagnosis,treatment and prognosis of rectal small cell carcinoma.Methods:Clinical data of 16 cases with rectal small cell carcinoma conifrmed by pathology from Jan. 2001 to Jan. 2013 in the Tumor Hospital Affiliated to Zhengzhou University Hospital were analyzed retrospectively.Results:Among the 16 rectal small cell carcinoma patients (mean age is 58.5 years), 9 were male, 7 were female; 4 cases in stageⅡ, 7 cases in stageⅢ and 5 cases in stageⅣ. Ten cases underwent surgical treatment, of which 6 cases underwent radical surgery, 4 cases underwent palliative surgery;6 cases received chemotherapy alone, 2 cases received chemoradiotherapy, 2 cases did not receive any treatment postoperatively. Five cases were lost opportunity for operation, of which 3 cases underwent chemotherapy alone and 2 cases underwent chemoradiotherapy. One case did not receive any treatment. Among 10 cases of resection of the lesions, 5 cases had vascular invasion and 7 cases had local lymph node metastasis. All patients received 7-65 months of follow-up. The median survival was 15.4 months. The 6 months, 1 year, 2 years, 3 years and 5 years survival rates were 58.4%, 46.2%, 26.6%, 13.1% and 6.2% respectively. The prognosis of patients was associated with tumor staging, presence of vascular invasion and lymph node metastasis, and type of operation (P<0.05); but not related to age, gender and tumor size (P>0.05).Conclusion:The biologic behavior of rectal small cell carcinoma which is a rare disease and similar to small cell lung cancer, and its prognosis is poor. Treatment methods include surgery, radiotherapy and chemotherapy. The overall result is poor.