切换至 "中华医学电子期刊资源库"

中华消化病与影像杂志(电子版) ›› 2018, Vol. 08 ›› Issue (05) : 210 -212. doi: 10.3877/cma.j.issn.2095-2015.2018.05.005

所属专题: 文献

临床研究

直肠神经内分泌肿瘤的诊治
张荣贵1, 张修礼1, 黄启阳1,()   
  1. 1. 100853 中国人民解放军总医院消化科
  • 收稿日期:2018-06-05 出版日期:2018-10-01
  • 通信作者: 黄启阳

Diagnosis and therapy of rectal neuroendocrine neoplasm

Ronggui Zhang1, Xiuli Zhang1, Qiyang Huang1,()   

  1. 1. Department of Gastroenterology and Hepatology , Chinese PLA General Hospital, Beijing 100853, China
  • Received:2018-06-05 Published:2018-10-01
  • Corresponding author: Qiyang Huang
  • About author:
    Corresponding author: Huang Qiyang, Email:
引用本文:

张荣贵, 张修礼, 黄启阳. 直肠神经内分泌肿瘤的诊治[J/OL]. 中华消化病与影像杂志(电子版), 2018, 08(05): 210-212.

Ronggui Zhang, Xiuli Zhang, Qiyang Huang. Diagnosis and therapy of rectal neuroendocrine neoplasm[J/OL]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2018, 08(05): 210-212.

目的

探讨直肠神经内分泌肿瘤的临床表现、内镜特点、病理及内镜下治疗。

方法

对解放军总医院2012年12月至2017年2月经临床及病理诊断为直肠神经内分泌肿瘤的22例患者进行回顾性分析。

结果

全部患者行内镜检查,内镜下均表现为表面光滑的直肠黏膜下隆起,色泽黄或者微黄。16例患者行微探头超声内镜检查,1例未探测到,余15例均起源于黏膜下层,14例表现为低回声改变。全部病例均行内镜下治疗,钳除5例,电凝电切1例,内镜下黏膜剥离(endoscopic submucosal dissection,ESD)12例,内镜下黏膜切除(endoscopic mucosal resection,EMR)3例,1例行外科手术切除。全部病例均行病理检查,21例行免疫组化,G1级11例,G2级10例,G3级0例。

结论

常规内镜、超声内镜对诊断直肠神经内分泌肿瘤有重要价值,包含EMR、ESD的内镜下治疗对直肠神经内分泌肿瘤安全、有效。

Objective

To investigate the clinical manifestations, features of endoscopy, pathology and endoscopic treatment of rectal neuroendocrine neoplasm(RNEN).

Methods

The clinical data of 22 patients with RNEN diagnosed by clinic and pathology were retrospectively analyzed.

Results

All patients underwent colonoscopy, and all the surface of RNEN were smooth.A total of 16 patients underwent endoscopic ultrasonography(EUS). Among them, 1 case could not be detected, and the remaining 15 cases originated from submucosa, and 14 cases were manifested as lesions with low level echoes.All the RNEN were removed by endoscopic therapy, including removing by biopsy for 1 case, electroresction for 1 case, endoscopic submucosal dissection(ESD)for 12 cases, endoscopic mucosal resection(EMR)for 3 cases and surgical operation for 1 case.All the cases of specimen were pathologically confirmed, and 21 cases were underwent immunohistochemical examination.Eleven cases were classified as grade G1, 10 cases as grade G2, and 0 case as grade G3.

Conclusion

The colonoscopy and EUS are very important to diagnose RNEN.The efficacy and safety of endoscopic therapy have been verified, which include EMR and ESD.

图1 直肠神经内分泌肿瘤肠镜和超声内镜下表现
1
Wang AY, Ahmad NA.Rectal carcinoids[J]. Curr Opin Gastroenterol, 2006, 22(5): 529-535.
2
Modlin IM, Kidd M, Latich I, et al.Current status of gastrointestinal carcinoids[J]. Gastroenterology, 2005, 128(6): 1717-1751.
3
Ni SJ, Sheng WQ, Du X. Pathologic research update of colorectal neuroendocrine tumors[J]. World J Gastroenterol, 2010, 16(14): 1713-1719.
4
Yao JC, Hassan M, Phan A, et al.One hundred years after " carcinoid" : epidemiology of and prognostic factors for neuroendocrine tumors in 35, 825 cases in the United States[J]. J Clin Oncol, 2008, 26(18): 3063-3072.
5
Godwin JD 2nd.Carcinoid tumors.An analysis of 2, 837 cases[J]. Cancer, 1975, 36(2): 560-569.
6
Naunheim KS, Zeitels J, Kaplan EL, et al.Rectal carcinoid tumors--treatment and prognosis[J]. Surgery, 1983, 94(4): 670-676.
7
Zhang W, Tong Q, Chen Z, et al.The usefulness of endoscopic ultrasound in the differential diagnosis between benign and malignant gastric ulcer[J]. Scand J Gastroenterol, 2010, 45(9): 1093-1096.
8
Chen HT, Xu GQ, Teng XD, et al.Diagnostic accuracy of endoscopic ultrasonography for rectal neuroendocrine neoplasms[J]. World J Gastroenterol, 2014, 20(30): 10470-10477.
9
郭旭,王向东,令狐恩强,等.小探头超声内镜在直肠光滑隆起型病变诊疗中的价值[J].胃肠病学与肝病学杂志,2014,23(4): 471-473.
10
马玲玲,孔文洁,黄晓玲,等.经内镜微探头超声检查对直肠黏膜下肿物的诊断意义[J].中华消化内镜杂志,2015,32(11): 758-759.
11
Kim J, Kim JH, Lee JY, et al.Clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor[J]. BMC Gastroenterol, 2018, 8(1): 77.
12
Palacios Salas F, Guzmán Calderón E, Liza Baca E, et al.Endoscopic treatment of rectal neuroendocrine tumors: multicentre study in Peru[J]. Rev Gastroenterol Peru, 2018, 38(1): 32-39.
13
Tsikitis VL, Wertheim BC, Guerrero MA.Trends of incidence and survival of gastrointestinal neuroendocrine tumors in the United States: a seer analysis[J]. J Cancer, 2012, 3: 292-302.
14
洪娜,王进.直肠神经内分泌肿瘤的临床病理特征及预后[J].世界华人消化杂志,2016,24(33): 4526-4530.
15
韦耿周,王玮,冯兴宇,等.直肠神经内分泌肿瘤的临床病理特征及预后分析[J].中华普通外科杂志,2017,32(10): 828-831.
16
吴凡,李鹏,赵宏,等.手术治疗直肠神经内分泌肿瘤的预后因素分析[J].中华医学杂志,2014,94(16): 1237-1240.
17
Nam SJ, Chae GB, Lee S, et al.A small, well-differentiated rectal neuroendocrine tumor with multiple lymph node metastases: A case report[J]. Oncol Lett, 2018, 15(5): 7139-7143.
18
Xu G, Wang P, Xiao Y, et al.Local resection of rectal neuroendocrine tumor with first clinical manifestation of giant liver metastasis by transanal endoscopic microsurgery: A case report[J]. Medicine(Baltimore), 2017, 96(50): e9153.
[1] 杨建波, 马欢, 黄小梅, 刘华柱. 结肠镜辅助下EMR、CSP和RFA术治疗直径<1cm结直肠息肉的疗效和安全性比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 76-79.
[2] 杜彦斌, 黄涛, 寇天阔, 石英. 双镜联合根治术与腹腔镜根治术在早期结肠癌患者中的应用效果[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(03): 275-278.
[3] 方红燕, 刘晓昌, 方家旭. 腹部按压联合综合护理在腹壁造口旁疝患者肠镜检查中的应用效果[J/OL]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 625-629.
[4] 张晓飞, 许慧芬, 韩开宇. 经EBUS-TBNA诊断肾透明细胞癌纵膈淋巴结转移一例[J/OL]. 中华肺部疾病杂志(电子版), 2023, 16(05): 755-756.
[5] 陈健, 周静洁, 夏开建, 王甘红, 刘罗杰, 徐晓丹. 基于卷积神经网络实现结直肠息肉的实时检测与自动NICE分型(附视频)[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(03): 217-228.
[6] 丁亚琴, 方旭, 戴彦成. 基于紧密型医联体的“一免三优先政策”在基层消化道肿瘤筛查中的应用探讨[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 481-484.
[7] 焦莉莉, 周芊池, 凌梦芸, 魏红玲, 徐缨. 血清SAA、CA19-9结合超声内镜对结直肠癌术前分期的诊断价值[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(02): 146-150.
[8] 孙欣欣, 刘军, 陈超伍, 孙超. 超声内镜引导细针穿刺抽吸术在胰腺占位性病变中的应用[J/OL]. 中华消化病与影像杂志(电子版), 2023, 13(06): 418-421.
[9] 许灿, 周鹏哲, 朱宁, 穆维娜. 超声内镜与磁共振胰胆管成像对胆总管泥沙样结石的诊断价值[J/OL]. 中华消化病与影像杂志(电子版), 2023, 13(05): 359-362.
[10] 孔绘敏, 王秀勤, 梁海. 硫酸镁钠钾口服液与复方聚乙二醇电解质散对患者肠道清洁的对比研究[J/OL]. 中华消化病与影像杂志(电子版), 2023, 13(04): 259-261.
[11] 曹友红, 吕翔, 张康伟, 袁晨, 徐甜, 唐月华, 马亦旻, 邢一鸣, 张以洋. 基于EUS 引导下ESD 对食管上皮下鱼刺的治疗[J/OL]. 中华胃肠内镜电子杂志, 2024, 11(04): 243-247.
[12] 李惠凯. EUS-FNA联合EPMB诊断胃壁增厚性疾病[J/OL]. 中华胃肠内镜电子杂志, 2024, 11(04): 288-288.
[13] 朱芮晴, 张荣贵, 冯秀雪, 张波, 刘圣圳, 柴宁莉, 令狐恩强. 基于倾向性评分匹配法的日间消化内镜超级微创手术治疗直肠神经内分泌肿瘤的疗效评价[J/OL]. 中华胃肠内镜电子杂志, 2024, 11(03): 166-170.
[14] 沈聪强, 田新宇, 米热阿依·努尔麦麦提, 庄宇航, 张松, 彭春艳, 黄淑玲, 沈珊珊, 张玮, 吕瑛. 胰腺导管内管状乳头状肿瘤的超声内镜特征分析[J/OL]. 中华胃肠内镜电子杂志, 2024, 11(03): 153-158.
[15] 程冰倩, 柴宁莉, 杜晨, 王湛博, 李惠凯, 冯秀雪, 高飞, 令狐恩强. 超声内镜引导下经穿刺针活检钳活检在胰腺囊性肿瘤诊断中的应用[J/OL]. 中华胃肠内镜电子杂志, 2024, 11(03): 147-152.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?