大肠类癌的诊断与治疗

Diagnosis and treatment of colorectal carcinoid

目的 探讨结直肠类癌的预后因素及外科治疗方法的选择。方法 回顾性分析1990～ 1999年经我院治疗的 4 6例结直肠类癌的临床资料。结果 大肠类癌男女之比为 1 4∶1。直肠类癌发病率高 ( 83 % ,3 8/ 4 6) ,肿瘤体积小 (直径 <2cm者占 82 % ,3 1/ 3 8) ,预后较好。肿瘤直径大于2cm的直肠类癌转移率为 71% ( 5 / 7) ,平均生存时间 2 5个月。结肠类癌发现晚 ,转移发生早 ,转移率为 83 % ( 5 / 6) ,大于 2cm结肠类癌平均生存时间 18个月。结论 结直肠类癌的大小 ,有无浸润及远处转移 ,是判断结直肠类癌良恶性、决定手术方式和预后的主要依据。

Objective To evaluate the prognosis and surgical therapy for colorectal carcinoid. MethodsClinicopathologic features of 46 patients with colorectal carcinoid were analyzed retrospectively. Results The Male/female ratio was 1 4/1. Tumor was located in the rectum in 83% of the cases, with a diameter of less than 2*!cm in 82%. The metastatic rate of the rectal carcinoid was 71% when the tumor >2*!cm and the median survival time was 25 months. Colonic carcinoid was found later than rectal tumor, with an incidence of metastasis of 83% and the median survival time was 18 months when lesion >2*!cm. Conclusions Large invasive and metastatic carcinoid tend to be malignant, and the prognosis is usually poor, with which a radical resection may help.