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目的探讨直肠类癌的临床病理特点及治疗。方法对32例经病理诊断的直肠类癌患者的临床资料进行回顾分析,总结其临床表现、治疗情况及随访结果。结果直肠类癌以腹痛(10/32)、大便习惯改变(15/32)、便血(5/32)为主要临床表现,部分为无症状体检时发现直肠黏膜下肿物(5/32)。29例直肠类癌位于肛门8cm以内,内镜下主要表现为半球状隆起,表面黏膜正常。其中17例行超声内镜检查,肿块多位于黏膜下层,为均匀或不均匀稍低回声,边界清晰。内镜下行EMR治疗32例,1例追加外科手术治疗。22例随访5月～5年,1例因伴肝、肺转移死亡,余21例无复发。结论直肠类癌缺乏特异性临床表现,诊断主要靠内镜及组织学检查,内镜下EMR切除是主要治疗方法。
Objective To investigate the clinicopathological features and treatment of rectal carcinoids. Methods The clinical data of 32 rectal carcinoid patients diagnosed by pathology were retrospectively analyzed, and the clinical manifestations, treatment and follow-up results were summarized. Results Rectal carcinoid was mainly clinical manifestations of abdominal pain (10/32), changes in bowel habits (15/32), blood in the stool (5/32), and partly asymptomatic submucosal mass (5/32). 29 cases of rectal carcinoid located within 8cm anus, endoscopic mainly hemispherical bulge, the surface mucosa is normal. Among them, 17 cases underwent endoscopic ultrasonography. Most of the tumors were located in the submucosa, which was uniform or uneven, and hypoechoic. The boundary was clear. Endoscopic EMR treatment of 32 cases, 1 case of additional surgical treatment. Twenty-two patients were followed up for 5 months to 5 years. One patient died of liver metastasis and lung metastasis, and another 21 patients had no recurrence. Conclusions Rectal carcinoid tumors lack of specific clinical manifestations, diagnosis mainly by endoscopic and histological examination, endoscopic EMR resection is the main treatment.