大肠类癌的内镜及超声内镜特点

Endoscopic and ultrasonic endoscopic features of colorectal carcinoid

目的探讨大肠类癌的内镜及超声内镜特点，提高内镜诊疗水平。方法收集2002—2007年收治的22例大肠类癌患者的临床资料。分析内镜及超声内镜特点及其与浸润深度的关系。结果早期癌内镜表现为直径〈1．5cm、黏膜光滑、黏膜内黄白色颗粒样结构；进展期癌内镜表现为直径0．8～3．0cm、黏膜不平、黄白色结节样或表面溃疡。超声内镜特征为：稍低回声，内部散在点状稍高回声，起源于黏膜固有层或黏膜下层不规则卵圆形结构，边缘模糊且不规则。16例黏膜内癌及黏膜下浅层癌行内镜黏膜切除术，其中10例追加氩气刀治疗。随访4～36个月无复发。1例黏膜下深层类癌及5例进展期类癌行外科手术。结论内镜及超声内镜可诊断大肠类癌及其浸润深度，对早期类癌行内镜治疗可取得较好效果。

Objective To investigate the endoscopic and ultrasonic endoscopic features of colorectal carcinoid and the indications of endoscopic treatment. Methods The clinical data of 22 patients with colorectal carcinoid who had been admitted to our hospital from 2002 to 2007 were collected. The endoscopic and ultrasonic endoscopic features and the relationship between the features and invasion depth of colorectal carcinoid were analyzed. Results Under the endoscope, early carcinoid presented submucosa tumor with 〈 1.5 cm in diameter, and yellow or white smooth surface; advanced carcinoid presented submucosa tumor with 0.8-3.0 cm in diameter, and yellow or white little nodus or ulcerative surface. The ultrasonic endoscopic feature of the colorectal carcinoid was orbicular-ovate low level echo tumor with punctiform slightly high-level echo and an unsharpness edge. Sixteen mucosal layer-cancers and submucosal layer-cancers were removed by endoscopic mucosal resection, and 10 of them were additional treated by argon plasma coagulation. After a follow-up period of 4-36 months, no recurrence was observed. Conclusions Endoscopy and endoscopic ultrasonography are effective methods to diagnose colorectal carcinoid and its invasion depth. Endoscopic treatment is a simple, safe and effective means to treat the early colorectal carcinoid tumors.