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目的探讨消化道类癌的临床特点、诊治及预后。方法回顾性分析北京大学深圳医院2004～2010年收治的43例消化道类癌患者临床资料。结果发病部位以直肠最多见(76.7%),其次为胃(18.6%)。内镜下大多直径≤1.0cm。免疫组织化学检查突触素(SYN)阳性率为100.0%(36/36),神经元特异性烯醇酶(NSE)阳性率为69.2%(9/13),嗜铬粒蛋白A(CGA)阳性率为55.6%(20/36)。2例合并其他恶性肿瘤,部分合并萎缩性胃炎伴肠化、胃黄色素瘤、大肠息肉和结肠黑变病。治疗方法主要是内镜切除和外科手术切除。21例随访3个月至5年,局部复发3例(14.3%),均无死亡。结论消化道类癌以直肠部位最多见,大多直径≤1.0cm,可合并其他恶性肿瘤及良性病变,免疫组织化学有助于提高诊断,内镜切除和外科手术是主要治疗手段,预后大多良好。
Objective To investigate the clinical features, diagnosis, treatment and prognosis of gastrointestinal carcinoid. Methods The clinical data of 43 patients with digestive tract carcinoid who were admitted to the Shenzhen Hospital of Peking University from 2004 to 2010 were retrospectively analyzed. Results The most common pathological site was rectum (76.7%), followed by stomach (18.6%). Most of the endoscopic diameter ≤ 1.0cm. Immunohistochemistry showed that the synaptophysin (SYN) positive rate was 100.0% (36/36), and the neuron-specific enolase (NSE) positive rate was 69.2% (9/13). Chromogranin A (CGA) The positive rate was 55.6% (20/36). Two patients were associated with other malignant tumors, some with atrophic gastritis with intestinal metaplasia, gastric yellow pigmentation, colorectal polyps, and colon melanosis. The treatment is mainly endoscopic resection and surgical resection. Twenty-one patients were followed up for 3 months to 5 years. Local recurrence occurred in 3 patients (14.3%) and no death occurred. Conclusion Carcinoids of digestive tract carcinoid are most common in the rectum. Most of them are less than or equal to 1.0 cm in diameter. They can be combined with other malignant tumors and benign lesions. Immunohistochemistry may help improve the diagnosis. Endoscopic resection and surgery are the main treatment methods, and the prognosis is mostly good.