摘要
目的探讨胃肠道类癌的内镜诊断及临床特征。方法回顾分析我院1995年1月至2005年12月收治的胃肠道类癌29例的内镜表现、活检病理及部分临床资料。结果29例患者术前各部位胃肠道类癌内镜及活检病理确诊情况:胃底贲门癌2/3例(66.7%);十二指肠类癌1/2例(50%);直肠类癌4/7例(57.1%);回盲部阑尾类癌6/8例(75.0%);结肠类癌5/8例(占62.5%);末段回肠类癌0/1例。误诊率37.9%。较早期类癌内镜下表现为表面光滑质地硬隆起型粘膜下层肿物,灰白色或黄色,部分病例内镜下可呈毛玻璃样外观,亚蒂或广基,大部分类癌内镜下与腺癌差别不大,难以区分,术前内镜活检病理诊断率65.5%。结论胃肠道类癌内镜表现特征不明显,活检病理取材准确性不高,结合免疫组化可能提高诊断准确率。
Obstractive To approach the endoscopic diagnosis and clinical feature of gastrointestinal tract carcinoid. Methods To retrospectively analyse the endoscope appearance,the patho-biopsy and parts of the clinicaldatas of 29 patiens who have suffered from gastrointestinal tract carcinoid in our hospital from 1995-1 to 2005-12. Results The preoperative endoscope and patho-biopsy final diagnosis information of 29 patiens who have suffered from gastrointestinal tract carciniod is as follow： there are 2/3 patiens who had carcinoma of gastric cardia and fundus gastricus （66.7%）;there is 1/2 that has suffered from duodenum carcinoid （50%） ;there are 4/7 patiens who have suffered from rectum carcinoid（ 51.7%）;there are 6/8 ones that suffered from carcinoid of appendix and ileocecal junction （75%）;there are also 5/8 subjects who had carcinoid of colon （62.5%）;there is 1 who has suffered from carcinoid of ileum,either without preoperative colonoscope and patho-biopsy final diagnosis.The fairly morning carcinoid under endoscope show that it is a protrude type submucosa tumor,with slicking surface and hard texture,and it is gray or yellow.The endoscope appearance of some patiens shows that it looks like frosted glass,and it is deuto-pedicel or wide base.The bulk carcinoids look almost the same with adenocarcinoma under endoscope.Thereford they are difficulte to discriminated.The diagnosis rate of patho-biopsy is 65.5%. Conclusion The endoscope characteristic appearance of gastrointestinal tract carcinoid isn＇t obvious.And the accuratissime ofpatho-biopsy to make ues of is low.However, if it combines with immunity,tissue and Chemistry methods,the accurate diagnosis rate maybe elevate.
关键词
胃肠道类癌
内镜
诊断
病理
gastrointestinal tract carcinoid
endoscope
diagnosis
patho-biopsy.
