31例胃肠道类癌诊治及预后分析.docVIP

31例胃肠道类癌诊治及预后分析 　　[摘要] 目的 探讨胃肠道类癌的诊断、外科治疗及预后。方法 回顾性分析我院2001年1月~2009年10月收治的31例胃肠道类癌患者临床、病理及随访资料。结果 所有患者均手术治疗并经病理证实,肿瘤病灶≤2cm与2cm患者5年生存率相比差异有统计学意义(P0.05);伴有淋巴结转移患者与不伴有淋巴结转移患者5年生存率相比差异有统计学意义(P0.05)。结论 胃肠道类癌的治疗以手术为主,肿瘤大小、浸润深度、淋巴结及远处转移与患者的预后重要相关。 　　[关键词] 胃肠肿瘤;诊断;外科治疗 　　[中图分类号] R735.2;R735.3 [文献标识码] A [文章编号] 1673-9701(2010)12-135-03 　　 　　Diagnosis and Treatment and Prognosis of Gastrointestinal Cancer 　　XIAO Yi 　　Department 5 of Surgery,Shaoyang City Center Hospital,Shaoyang 422000,China 　　 　　[Abstract] Objective To explore the diagnosis,surgical treatment and prognosis of gastrointestinal cancer. Methods A retrospective analysis was made of the clinical and pathological and follow-up data of 31 cases of gastrointestinal cancer in our hospital from Jan. 2001 to Oct 2009. Results All cases received surgical treatment and pathology confirmed that the 5-year survival rate of those whose tumor lesions were ≤2cm or ≥2cm with more showed significant differences compared with the control group(P0.05). There was a significant difference in the 5-year survival rate between those with lymph node metastasis and those without lymph node metastasis(P0.05). Conclusion Gastrointestinal cancer is treated mainly by surgery and tumor size,invasive depth,lymph node and distant metastasis are closely correlated with its prognosis. 　　[Key words] Gastrointestinal cancer;Diagnosis;Surgical treatment 　　胃肠道类癌是一种特殊类型的恶性肿瘤,起源于肠黏膜隐窝深部的肠嗜银细胞,在临床上极为少见,发生率占胃肠道恶性肿瘤的0.4%～1.8%,占所有肿瘤的0.05%～0.2%[1]。胃肠道类癌可发生在胃肠道的任何部位,以阑尾最常见,其余依次为小肠、直肠、结肠和胃[2]。由于缺乏特异性的症状和体征,术前诊断较为困难,易造成误诊。现回顾性分析我院2001年1月～2009年10月治疗的31例胃肠道类癌患者临床、病理及随访资料,并结合复习相关文献报道如下。 　　1资料与方法 　　1.1一般资料 　　本组患者31例,男21例、女10例,男女比例为2.1∶1。年龄30～79岁,平均年龄59岁。病程2d～2年,中位病程1个月。临床表现主要为腹痛16例(51.6%),急性肠梗阻3例(9.7%),腹胀、消瘦、纳差7例(22.6%),呕血和(或)黑便5例(16.1%),腹泻6例(19.4%),贫血2例(6.5%),腹部包块、发热2例(6.5%)。本组1例患者具有类癌综合征,主要表现为发作性心悸、腹泻以及面部潮红。术前胃镜和肠镜检查19例(61.3%),其中1例胃窦部类癌和5例结直肠类癌活检确诊,其余均误诊为不同分化程度的腺癌,误诊率68.4%。9例阑尾类癌术前因误诊为急、慢性阑尾炎而行手术治疗。肿瘤部位:胃类癌5例(16.1%),胃低分化腺癌伴不典型类癌1例(3.2%)、阑尾类癌9例(29%