摘要
目的 分析不同病理类型胃肠类癌的临床特点 ,以提高对该类疾病的认识与诊治水平。方法 回顾性分析北京协和医院 1982～ 2 0 0 3年的病理分类胃肠类癌 36例 ,并根据世界卫生组织肿瘤国际组织学新分类标准 (2 0 0 0 )分为恶性类癌、类癌 2组 ;比较 2组类癌的发病年龄特点、临床表现差异、转移情况、在消化系统内分泌肿瘤和肿瘤中的发病比例以及确诊的主要手段等。结果 (1)患病比 :胃肠类癌占同期消化系统肿瘤的 0 .35 % ,占同期消化系统内分泌肿瘤的 10 .2 0 %。 (2 )年龄 :恶性类癌发病年龄为 (5 5 .8± 12 .8)岁 ,类癌发病年龄为 (45 .1± 12 .0 )岁 ,前者明显高于后者。 (3)部位 :类癌多发于直肠 (6 3% ) ,而发生于胃 (35 % )与结肠 (2 5 % )应考虑恶性类癌。(4)转移 :淋巴结与肝脏是恶性类癌常见的转移部位 (6 0 % ) ;胃与结肠部位的恶性类癌转移率明显高于直肠与其他部位。(5 )检查手段 :胃肠类癌的发现多依赖内镜检查 ,但直肠指检不应偏废。 (6 )类癌综合征的发生率低 ,恶性类癌多见。结论 胃肠类癌在消化系统肿瘤中的发病率较低 ,但并非罕见 ;直肠是类癌的好发部位 ,胃与结肠是恶性类癌的好发部位 ;恶性类癌发病年龄较大且易伴肝与淋巴结转移 ,类癌综合征多见于恶性类癌。
Objective To analysis the clinical features of gastrointestinal(GI) carcinoid tumor in different pathological types, and to improve the level of its diagnosis and treatment.Methods Retrosp ectively analysis 36 cases of GI carcinoid in Peking Union Medical College Hospital from 1982 to 2003, according to the International Classification of Disease for Oncology (ICD O). The 36 cases were divided into carcinoid group and malignant carcinoid group. Their clinical presentation, metastasis, age, its ratio in gastrointestinal endocrine and non endocrine tumor were compared.Results (1)Ratio: the ratio of GI carcinoid in digestive system non endocrine tumor was 0.35%, in endocrine tumor was 10.20%.(2) Age: the mean age of the malignant carcinoid group was (55.8±12.8) years old and carcinoid group was (45.1± 12.0). The age of the malignant carcinoid group is significantly higher than that of the carcinoid group. (3)Sites: the rectum carcinoid (63%)was the most common site of the overall GI caiciniod, the gastric (35%)and colonic (25%) carcinoid in the malignant carcinoid group were found more than that in carcinoid group. (4)Metastasis:the lymphonode and liver (60%)were most common sites of malignant carcinoid tumor. The ratio of metastasis from stomach and colon was higher than that from the other gastrointestinal sites.(5)Diagnostic methods: most of the GI carciniod tumors were diagnosed by the colonscopy. The rectal touch should not be neglected. (6)Carcinoid syndrome : The incidence of carcinoid syndrome was quite low and often occurred in malignant carcinoid tumor. Conclusions The overall incidence of GI carcinoid tumor makes up 0.35% of gastrointestinal tumor. It is not common disease but not rare. The rectum is most common site of carciniod tumor. Most of the gastric and colonic carciniod tumor was belonging to malignant. The mean age of malignant carcinoid tumor was older with the metastasis of lymphonode and liver. The carcinoid syndrome often occurred in malignant carcinoid tumor.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2004年第12期900-902,共3页
Chinese Journal of Internal Medicine
关键词
临床分析
类癌瘤
胃肠肿瘤
内分泌腺肿瘤
Carcinoid tumor
Gastrointestinal neoplasms
Endocrine gland neoplasms
