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1、·36·广 州 医 药 2005年第36卷第1期直肠类癌的临床诊断与治疗策略分析(附34例报告)112郑少忠 郑永林 李 玺1 广东省汕头市潮南区人民医院普通外科(515144);2 中山大学附属第三医院外科(广州 510630) 【摘 要】 目的 探讨直肠类癌的生物学行为、临床表现、诊断、外科治疗及预后,提高对该病的诊治水平。方法 回顾性分析经病理证实的34例直肠类癌的临床资料。结果34例中,男21例,女13例。病史1周～4年,主要症状是大便次数增多,血便或黏液脓血便,临床无明显症状者10例。肿瘤距肛缘12cm以
2、上者3例,8～12cm者9例,5～8cm者11例,3～5cm8例,3cm以下者3例;肿瘤直径:>2cm4例,1～2cm23例,<1cm7例。34例均行局部切除术或局部扩大切除术,31例经肛,3例经腹。34例中29例获得随访(8513%),24例得到5年随访,5年生存率9518%(35/24),未发现局部复发和转移,1例在手术后3年死于心肌梗死。结论 对每一位直肠类癌患者均应根据其肿瘤大小、浸润范围、有无局部淋巴结转移和远处脏器转移等情况采用个体化治疗方案。早期发现、早期诊断和早期根治性治疗是进一步提高患者生存率的关键
3、。 【关键词】 直肠类癌 神经内分泌细胞 生物学行为Ananalysisaboutthediagnosisandtreatmentprocedureofcarcinoidtumoroftherectum(34cases)112ZhengShaozhong,ZhengYonglin,LiXi11TheGeneralDepartment,People’sHospitalChaonanDestrict,Shan2touCity,GuangdongProvince,515144;2TheGeneralSurgeryDepa
4、rtment,theThirdAffliatedHospital,Zhong2shanUniversity,Guangzhou,GuangdongProvince,510630【Abstract】ObjectiveToinvestigatethebiologicbehavior,clinicalmanifestation,diagnosis,surgicaltreatmentandprognosisinpatientswithrectalcarcinoids1MethodsTherewere48casesofrect
5、alcarcinoidswhosemedicalrecordsofhospi2talizationwerereviewedretrospectively,andallcaseshadbeenconfirmedbypathologicaldiagnosis1ResultsTherewere21malesand13femalesinallpatientswithrectalcarcinoidswhosehistorieswerefrom1weekto4years1Themainlysymptomswerefrequent
6、stool,bloodystool,bloodypurulentstool,andtherewere10caseswhohadnoanysymptomwhendiag2nosed1Distancefromanalvergetothelocationofrectalcarcinoidswereasfollow:morethan12cm,3cases;from8cmto12cm,9cases;from5cmto8cm,11cases;from3cmto5cm,8cases;lessthan3cm,3cases1Thedi
7、ametersoftumorwereasfollows:morethan2cm,4cases;from1cmto2cm,23cases;lessthan1cm,7cases1Allcaseshadlocalresectionorlocalradicalresection,amongwhich31casesoperatedthroughannalsand3casesthroughabdomen1Therewere29caseswhogotfollow2up,andthefollow2upratewas8513%1The
8、rewere24caseswhogot52yearsfollow2upwiththe52yearssurvivalrateof9518%(35/24),andnolocalrecurrenceanddistalmetastaticmassweredetected1Therewas1casewhodiedofmyecardiainfarction
