65例直肠神经内分泌瘤合并大肠息肉的病理特征及预后分析

Pathological features and prognosis of rectal neuroendocrine tumors coexisted with colorectal polyps: An analysis of 65 cases

  • 摘要: 目的 探讨直肠神经内分泌瘤合并大肠息肉的临床病理特征、治疗及预后。 方法 回顾解放军总医院2012年1月-2015年1月收治的直肠神经内分泌瘤病例,对比分析直肠神经内分泌瘤合并大肠息肉与同期未合并大肠息肉病例的临床病理特征、治疗及预后情况。 结果 共收集到65例患者的临床资料,年龄29~77(50.09±11.12)岁,男女比例1.7∶1。其中23例(35.4%)合并大肠息肉,42例(64.6%)未合并大肠息肉。合并大肠息肉组的平均年龄(55.83±11.12)岁,男性所占比例87.0%,症状发生率82.6%;未合并大肠息肉组的平均年龄(46.95±9.91)岁,男性所占比例50.0%,症状发生率57.1%;两组的年龄、性别、症状发生率差异有统计学意义(P< 0.05),病变的形态、大小、位置分布、单发与多发比例、病理分级差异无统计学意义。26例(40.0%)行超声内镜检查,对浸润深度的判断准确率为95%(25/26)。所有患者均进行了内镜下治疗,1例发生术后出血,2例追加外科手术治疗。所有患者均获得随访,无肿瘤局部复发及远处转移。 结论 直肠神经内分泌瘤合并大肠息肉组较未合并息肉组年龄更大,男性所占比例及症状发生率更高。内镜下治疗能够获得满意的疗效,超声内镜能够很好地判断肿瘤浸润深度,有助于内镜下治疗的术前评估。

     

    Abstract: Objective To explore the clinicopathological features, treatment and prognosis of patients with rectal neuroendocrine tumors coexisted with colorectal polyps. Methods Medical records of patients with rectal neuroendocrine tumors who were diagnosed and treated in our department from January 2012 to January 2015 were collected. All patients were divided into two groups by coexisting with colorectal polyps or not. The clinicopathological features, treatment and prognosis were comparatively analyzed. Results A total of 65 patients were enrolled with the mean age of (50.09±11.12) years (ranging from 29-77 years) and male/female ratio of 1.7∶1. The colorectal polyps were coexisted in 23 patients (35.4%), and the other 42 cases (64.6%) were found no colorectal polyps. Significant difference was found in mean age, gender ratio and symptom prevalence between two groups (55.83±11.12) years vs (46.95±9.91) years, 87.0% vs 50.0%, 82.6% vs 57.1%, P< 0.05. But the type, size, location, pathological grade of the tumors showed no difference between two groups. Twenty-six patients (40.0%) had undergone endoscopic ultrasonography, and the depth of invasion of the tumors was correctly identified in 25 cases (95%). All patients had undergone endoscopic resection procedure, and postoperative bleeding occurred in 1 patient. Additional surgeries were performed in 2 patients. Recurrence or metastasis was not found during the follow-up. Conclusion Patients in rectal neuroendocrine tumors coexisted with colorectal polyps group are significantly older than those in group without colorectal polyps, and the male/female ratio and symptom prevalence are also higher. Endoscopic therapy of the tumor can achieve excellent effect regardless of whether coexisting with colorectal polyps, and endoscopic ultrasonography can accurately assess the depth of invasion of the tumors, which is particularly important to the preoperative evaluation.

     

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