摘要
目的 总结早期大肠癌的临床病理组织学特点，探讨不同临床特点的早期大肠 癌的治疗方法。方法 对 16年间经内镜发现并术后病理证实的早期大肠癌 105例 106个病 变，进行临床病理学分析。结果 早期大肠癌中 91.5％的病变位于乙状结肠以下。内镜下 的肉眼形态分别为：Ⅰ p型 34个，Ⅰ ps型 13个，Ⅰ s型 26个，Ⅱ a型 11个，Ⅱ a＋Ⅱ c型 22个。其中Ⅱ a＋Ⅱ c型的 22个病变中 21个为粘膜下的癌 (Sm)。 Sm癌的 25个病变 中出现 3例 (12％ )淋巴结转移。治疗上，经内镜下切除 13个病变 (12例 )，其中 1例 Sm 癌术后局部复发，行根治性手术。单纯局部切除术或者肠管切除术加淋巴结清扫术 93个病 变。结论 Ⅱ a＋Ⅱ c型的大部分为 Sm癌；低、中分化腺癌中以 Sm癌多见；淋巴结转移仅 出现在 Sm癌中，凡出现上述情况之一的，均应行根治性手术。
Objective The gross appearance and histopathology as well a s the treatment of early colorectal carcinoma were investigated. Methods The clinical documents and histopathology of 105 cases(106 lesions) with early color ectal carcinoma detected by colonoscopy and proved pathologically after operatio n in past 16 years were retrospectively reviewed and analysed. Results 91.5％ of the early colorectal carcinoma were located distal to the sigmoid.The macro scopic type of these lesions under colonoscopy was classified as Ip type in 34 l esions,Ips type in 13,Is type in 26,Ⅱ a type in 11,Ⅱ a＋Ⅱ c type in 22(in whi ch 21 lesions are Sm carcinoma).Lymph node involvement was observed in 3 cases o f the 25 with Sm carcinoma (accounting for 12％ ).13 lesions(in 12 cases)were re moved under the colonoscopy,local recurrence was found in one case of Sm carcino ma during the follow up period and treated with radical operation.93 lesions(in 93 cases)were treated by local resection or radical surgery. Conclusions Most of the carcinomas withⅡ a＋Ⅱ c type were sm carcinoma.Histopathologically mos t of Sm carcinomas were poorly or moderately differentiated adenocarcinomas.Lymp h node involvement only appeared in Sm carcinoma.Radical operation should be per formed in the following conditions (1)the macroscopic type isⅡ a＋Ⅱ c type,(2) the histopathologic type is poorly differentiated adenocarcinoma,(3)involvement of submucosa or lymph node metastasis
出处
《中华消化内镜杂志》
2001年第3期139-141,共3页
Chinese Journal of Digestive Endoscopy
