48例直肠神经内分泌肿瘤的临床分析

Clinical Analysis of 48 Cases of Rectal Neuroendocrine Neoplasm

目的探讨直肠神经内分泌肿瘤的临床特征及治疗方法。方法回顾性分析48例直肠神经内分泌肿瘤的病史、临床表现、诊断方法、手术方式及预后。结果早期直肠神经内分泌肿瘤无明显临床表现,中晚期直肠神经内分泌肿瘤多有排便习惯及性状的改变。直肠指检是最简便、最直接的检查方法,联合肠镜和活检可使诊断率达到92.7%。根据直肠神经内分泌肿瘤的大小及浸润深度可进行局部切除术,局部扩大切除以及根治术。6例行内镜下切除术,21例行局部切除术,12例行局部扩大切除术,9例行根治术。患者总体1年生存率为100%,3年生存率为92.1%,5年生存率为81.5%。结论直肠神经内分泌肿瘤发病率低,症状不典型,肛诊、肠镜及活检可提高其诊断率。治疗直肠神经内分泌肿瘤首先手术治疗,根据其大小、浸润深度以及淋巴结转移情况选择不同术式。

Objective To explore the clinical features and treatment of rectal neuroendocrine tumors.Methods Retrospective analysis of clinical manifestations,diagnostic methods,surgical methods and prognosis of 48 cases of rectal neuroendocrine tumors were conducted.Results Early rectal neuroendocrine tumors had no obvious clinical manifestations,and middle and late rectal neuroendocrine tumors have many bowel habits and trait changes.Digital rectal examination was the easiest and most direct method of examination.Combined colonoscopy and biopsy can make the diagnosis rate reach 92.7%.According to the size and depth of invasion of rectal neuroendocrine tumors,local excision,local enlargement and radical surgery can be performed.6 patients underwent endoscopic resection,21 underwent partial resection,12 underwent partial resection,and 9 underwent radical surgery.The overall 1-year survival rate was 100%,the 3-year survival rate was 92.1%,and the 5-year survival rate was 81.5%.Conclusion The incidence of rectal neuroendocrine tumors is low,and the symptoms are not typical.Anal examination,colonoscopy and biopsy can improve the diagnosis rate.The treatment of rectal neuroendocrine tumors is first treated surgically,and different procedures are selected according to their size,depth of invasion,and lymph node metastasis.