摘要
研究直肠高级别上皮内瘤变经肛肿瘤切除术后pT1b直肠癌患者再行补救性根治术后的临床病理特点、合理的治疗方案及手术指征。经乙状结肠镜或结肠镜活检诊断为41例直肠高级别上皮内瘤变,随后Park经肛直肠肿物切除术或经肛内镜显微手术后确诊为34例≥pT1b直肠癌,再行补救性根治术后最终诊断为29例pT1b直肠癌。pT1b直肠癌按浸润深度分为SM1-2组和SM3组,观察两组临床病理特点。Multivariate回归分析结果,发现淋巴脉管浸润是肿瘤浸润深度的独立预测因素(P<0.05)。直肠高级别上皮内瘤变需积极行经肛肿瘤切除术确诊;当其术后浸润深度为SM3的pT1b直肠癌合并淋巴脉管浸润时,建议行积极的补救性根治术等再手术干预。
To investigative the clinicopathological characteristics,reasonable treatment plan and surgical indications for pT1 brectal carcinoma was diagnosed with rectal high-grade intraepithelial neoplasia（RHIN）after transanal tumor resection.Forty-one patients with RHIN diagnosed by the sigmoscopy or colonoscopy biopsy,and thirty-four patients were diagnosed as greater then the clinical value of pT1 bstage rectal carcinoma after Park＇s transanal excision or transanal endoscopic microsurgery,and twentynine patients with pT1 bstage rectal carcinoma after remedial radical surgery were retrospectively analyzed.The pT1 bstage rectal carcinoma were divided into two groups of SM1-2or SM3 by the depth of infiltrated,and analyzed for the clinicopathological characteristics.A large proportion of biopsy-proven RHIN are invasive carcinoma,and local resection should be performed to confirm diagnosis.Remedial radical surgery should be considered SM3 of depth of infiltration of pT1 bstage rectal carcinoma when lymphovascular invasion are present in the after transanal tumor resection.
出处
《医学与哲学（B）》
2017年第1期46-49,共4页
Medicine & Philosophy(B)
基金
2013年大连市科技计划项目(2013E15SF42)
2013年辽宁省教育厅科学技术研究项目(L2013484)
关键词
直肠高级别上皮内瘤变
pT1b直肠癌
临床病理特点
补救性根治术
rectal high-grade intraepithelial neoplasia
pT1bstage rectal carcinoma
clinicopathological characteristics
remedial radical surgery
