直肠类癌的临床病理特征及预后分析

Clinicopathologic characteristics of rectal carcinoid and prognosis

目的分析直肠类癌的临床病理特征、外科治疗方法及其长期疗效。方法对1966年1月至2004年12月手术治疗的74例直肠类癌患者的临床资料进行回顾性分析,按照不同危险因素分组进行统计学分析,比较各组手术治疗效果和生存率。结果 1,3,5年累计生存率分别为98.9%、94.3%和89.2%,直肠类癌最大径≤2.0 cm组与最大径>2.0 cm组的生存比较差异有显著性(P<0.05);未侵犯肌层组与浸润肌层组的生存比较差异有显著性(P<0.05)。结论肿瘤大小和肌层浸润是决定直肠类癌手术方式的关键,也是影响预后的两个重要相关因素,肿瘤最大径>2 cm、肌层浸润的直肠类癌预后不良,应综合考虑采用个体化治疗方案。早期发现、早期诊断和根治性治疗是进一步提高患者生存率的关键。

Objective To investigate the clinicopathologic characteristics,the therapeutic principles and prognosis of rectal carcinoid.Methods The data of 74 patients with rectal carcinoid surgically treated from Jan 1966 to Dec 2004 were reviewed retrospectively.The patients were divided into groups based on different risk factors.The post-operative therapeutic effectiveness and survival rate were compared between groups.Results The 1-year,3-year and 5-year cumulative survival rates were 98.9%,94.3%and 89.2%,respectively.The patients were divided into two groups based on the tumor size and muscular infiltration.There was a statistically significant difference in the survival rate between the tumor≤2.0cm and 2.0cm groups（P0.05）.There was a statistically significant difference in the survival rate between the group without muscular infiltration and the group with muscular infiltration（P0.05）.Conclusion Tumor size and muscular infiltration play key roles in the determination of surgical method for rectal carcinoid,they are important prognostic factors.Large tumor and deep invasion are the main risk factors.The therapy of rectal carcinoid should be individualized according to the above factors,and the key factors to improve the efficacy of operation are finding the rectum carcinoid,making diagnosis and treating the disease as early as possible.