Objective To investigate the clinical manifestations,pathological features,endoscopic diagnosis and treatment and prognosis of rectal neuroendocrine tumors.Method The clinical data of 69 patients with rectal neuroendocrine tumors diagnosed and treated by colonoscopy in our hospital from 2010 to 2016 were retrospectively analyzed,and the outcome of the difference therapeutic methods was compared.Result All patients underwent colonoscopy,39 of whom underwent endoscopic ultrasonography.The tumors were removed completely by endoscopic resection,including endoscopic submucosal dissection (ESD),endoscopic mucosal resection (EMR),electroresection and Cap-aspiration lumpectomy (CASL) Sixty-nine cases of specimen were pathologically confirmed,20 cases underwent immunohistochemical examination,consistented with the diagnosis of neuroendocrine tumors.The age,gender,lesion size,distance from anus,depth of invasion,length of hospital stay and incidence of complications in 4 groups were compared,and the result showed that (1) the lesion size of EMR group was smaller than that of ESD group and electroresection group (P=0.021,P =0.017);(2)the length of hospital stay in ESD group was longer than that in EMR group (P =0.004).Conclusion The colonoscopy might be the first choice to diagnose rectal neuroendocrine tumors,and endoscopic ultrasonography was recommended to confirm the size and depth of invasion of the tumors.The efficacy and safety of endoscopic therapy have been verified,and EMR might be more recommended currently.%目的 探讨直肠神经内分泌肿瘤的临床表现、病理特点、内镜下诊疗及预后.方法 回顾性分析南方医院2010年至2016年收治的69例行内镜下治疗的直肠神经内分泌肿瘤患者临床资料,比较不同内镜治疗方法的差异.结果 69例患者均行结肠镜检查,其中39例行超声内镜.均在内镜下完整切除病变,主要采用内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)、内镜下黏膜切除术(endoscopic mucosal resection,EMR)、电凝切除及透明帽辅助黏膜下肿物切除术(Cap-aspiration lumpectomy,CASL)4种方法,69例标本送检得到病理确诊,其中20例行免疫组织化学检查,符合神经内分泌肿瘤诊断.比较四组患者的年龄、性别、病变大小及距肛门距离、浸润深度、住院时间及并发症发生率等指标,结果显示,EMR组病变直径比ESD组及电凝切除组小(P=0.021,P=0.017);ESD组住院时间比EMR组长(P=0.004).结论 直肠神经内分泌肿瘤诊断首选结肠镜,推荐行超声内镜明确病变大小及浸润深度.内镜下治疗直肠神经内分泌肿瘤的有效性及安全性已经得到证实,其中EMR为目前推荐的方法.
展开▼
