结直肠类癌内镜下诊断及治疗51例

Diagnosis and treatment of colorectal carcinoid tumors with endoscopy:an analysis of 51 cases

目的:探讨结直肠类癌的内镜下诊断及治疗.方法:收集1986-04/2008-08我院经结肠镜检查并病理证实的类癌51例.分析其形态学特点、结肠镜下治疗及预后.结果:结直肠类癌男性明显多于女性(1.83∶1),平均年龄53.0±13.2岁,直肠最多见(86.3%),最大径多小于1.0cm(74.5%),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,≥2.0cm多发生转移,≤1.0cm者EMR法切除均无复发,6例术前行超声内镜检查,明确内镜下治疗的可能性.结论:掌握内镜下类癌的特点有助于提高肉眼诊断,深凿活检或EMR切除活检有助于提高诊断率,≤1.0cm的类癌内镜下切除安全、有效.

AIM： To study endoscopic diagnosis and management of colorectal carcinoid tumors. METHODS： Fifty one patients were certified by colonoscopy and pathology during April 1986 to August 2008. Morphologic characteristics, trans- endoscopic treatment and prognosis were docu- mented for further analysis. RESULTS： Male patients significantly outnum- bered female patients with a ratio of 1.83. The average age was 53.0 ± 13.2 years. The most frequent occurrence location was rectum with almost 86.3 percents. Most carcinoid tumors, about 74.5%, were smaller than 1.0 cm in diameter. The classic characters were submucosal tumor with yellow color and rigid or tough tex-ture, and always were lack of activities. There was metastasis of tumor when it was bigger than 2.0 cm, and there was no recurrence for smaller ones （≤1.0 cm） after EMR. Six patients had un- dergone endoscopic ultrasonic examination and it was very helpful for EMR. CONCLUSION： Understanding the endoscopic characters of colorectal carcinoid tumors was helpful for correct diagnosis. Deep biopsy and EMR can help improve the correct diagnosis rate. EMR is safe and effective for carcinoid tu- mors with a diameter less than 1.0 cm.