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目的 探讨大肠非上皮来源恶性肿瘤的临床病理学特征 ,以提高其诊治水平。方法回顾分析 1975～ 1996年间收治的大肠非上皮来源恶性肿瘤的临床病理学特征、治疗及预后。结果(1)本病缺乏特异临床表现 ,无典型脓血便、粘液血便等症状。 (2 )X线及内窥镜检查时无明显的粘膜破坏 ,往往仅提示外压性改变。 (3)诊断须依靠病理与临床相结合的方法确定。 (4)扩散方式以血行转移及局部复发为主 ,15例平滑肌肉瘤以及 6例淋巴肉瘤均有局部复发。 (5 )本病应以手术切除为主 ,局部复发者多数可再次甚至多次手术切除 ,除淋巴肉瘤外 ,对放、化疗不敏感。 (6 )生存率明显低于大肠癌。结论 本病缺乏特异性临床表现 ,往往易误诊、漏诊 ,术后易局部复发及血行转移。
Objective To investigate the clinicopathological features of non-epithelial malignant tumors of the large intestine to improve its diagnosis and treatment. Methods The clinical pathological features, treatment and prognosis of non-epithelial malignant tumors of the colon from 1975 to 1996 were analyzed retrospectively. Results (1) There was no specific clinical manifestation of the disease, and there were no typical symptoms such as pus and blood, mucus, and bloody stool. (2) There is no obvious mucous membrane damage during X-ray and endoscopy, and often only changes in external pressure are indicated. (3) The diagnosis must be determined by a combination of pathology and clinical methods. (4) Proliferation was mainly based on hematogenous metastasis and local recurrence. 15 cases of leiomyosarcoma and 6 cases of lymphosarcoma all had local recurrence. (5) The disease should be treated with surgical resection. Most local recurrences can be performed again or even after surgery. In addition to lymphosarcoma, they are not sensitive to radiotherapy and chemotherapy. (6) The survival rate was significantly lower than that of colorectal cancer. Conclusions The lack of specific clinical manifestations of the disease often leads to misdiagnosis and missed diagnosis, and local recurrence and hematogenous metastasis after surgery.