消化道类癌的诊治（附35例临床分析）

目的：探讨消化道类癌的诊断、分类和治疗方法。方法：３５例消化道类癌根据其来源可分为前肠、中肠、后肠３类。全组病人根据病情采用多种手术方式。８例伴有进展期肝转移的病人采用全身化疗或肝动脉栓塞化疗。结果：全部病人确诊依靠病理检查。临床误诊率达７１．４％。随访２９例五年生存率为８２．７％。结论：判断类癌良恶性应综合考虑以下７个因素，即肿瘤大小、肿瘤位置、肿瘤浸润深度、多中心性肿瘤、肿瘤侵犯血管的程度、转移及类癌综合征。在治疗中，应根据类癌的良恶性决定手术范围，对已有远处转移者仍应争取切除原发病灶，对多发性肝转移者应首选介入放射下肝动脉插管栓塞化疗。

On Diagnosis and Treatment of Alimentary Carcinoid Tumors:A Clinical Analysis of 35 Cases

OBJECTIVES: To study the diagnosis, classification and treatment of the alimentary carolnoid. METHODS:Thirty-five Patients with alimentary carcinoid were divided into Foregut,Midgut and Hindgut groups according to its embryogeny and derivation. All the patients received surgical operations. The chemoembolization of chemotherapy was performed on & patients with prDgressive carcinoid liver metastasis. RESULTS:Initial diagnosis was made by histological evaluation on specimens obtained by laparotomy and laparoscopy. The clinical rnisdiagnosis was 71. 4% of 29 followed-up cases. The 5-year survival rate was 82. 7%. CONCLUTIONS:In evaluating the nature of a tumor,attention should be Paid to such actors,as the size,the site,the depth of penetration into the bowel wall,the extent of infiltration into the vesseles and lymph--vesseles, the multicentricity, the metastasis and carcinoid syndrome. The extent and method of operation should be decided individually. For resection of primary tumor should be strived for patients with remote metastasis. The transcatheter chemoembolization should be first selected in patients with progressive carcinoid liver metastasis.