直肠神经内分泌肿瘤的分布特征与治疗

Distribution and treatment of rectal neuroendocrine tumors

目的总结直肠神经内分泌肿瘤（NET）的临床分布特征和外科治疗方法。方法分析2004年1月至2009年6月南京中医药大学第三附属医院11例经治疗的直肠NET患者的临床资料。结果11例直肠NET占同期直肠恶性肿瘤的1．49％，男性6例，女性5例，肿瘤距肛缘3～7cm，无转移。其中4例在距肛缘4cm以内，占36．4％。所有患者均行外科治疗，4例经肛门行局部扩大切除；6例行内镜下黏膜切除，其中5例术后病理基底部无肿瘤，进行常规随访，1例术后病理提示基底见癌细胞，进行经肛局部扩大切除。另外1例患者肿瘤距肛缘7cm，直径1．5cm，行直肠前切除术。11例患者均得到随访，时间1～78个月（中位随访时间36个月），无复发。结论直肠NET临床少见，发生于直肠远端较多，其外科手术原则与直肠腺癌相似。

Objective To investigate the clinical distribution characteristics and surgical therapy strategy of rectal neuroendocrine tumors（NET）. Methods From Jan. 2004 to June 2009 in the 3rd affiliated Hospital of Nanjing University of Traditional Chinese Medicine ,rectal neuroendocrine tumors were diagnosed in 11 patients. Clinical data were obtained retrospectively from a review of hospital charts. Eleven patients were all followed up postoperatively. Meanwhile, the relevant literatures were reviewed. Re- suits Of 11 cases （ 1.49% of all rectal cancers） , there were 6 females and 5 males. All tumors located at the rectum ranging 3 - 7 cm to the anal verges. All NET were small without clinical or biochemical signs of metastasis. The NET in 4 cases （ 36.4% ） were within 4 cm away from the anal verges. All patients received surgical approaches, including endoscopic mucosal local resection in 6 cases, wide excision in 4 cases ,and one case of NET within 7 cm away from the anal verges（ tumor size was 1.5 cm） accepted anterior resection of rectum. All patients were followed up for 1 -78 months （mean 36 months ） , and there was no recurrence. Conclusion Rectal NET are rare, but the distal rectum is the most common site of NET in gut. It is slightly more common in males than in females, and its therapy strategy is similar as adencarcinoma.