小儿大肠癌-附2例报告及文献复习

目的 提高对小儿大肠癌的认识,减少误诊.方法介绍我院十年来收治的2例小儿结肠癌的诊治经过,并复习有关文献报道,加以总结.结果本组两例分别于发病后4个月至半年经钡灌肠及结肠镜明确诊断并手术,病理报告均为粘液腺癌,部分呈印戒细胞型,1例已死亡,另1例术后6个月经化疗后目前身体状况尚好,无复发迹象.结论 小儿大肠癌50%以上为恶性程度较高的粘液腺癌,预后差,结肠镜及钡灌肠有助于诊断.早期诊断,彻底切除,术后辅助放化疗有望改善预后.

Colorectal carcinoma in children: a report of 2 cases and a literature review

Objective Colorectal carcinoma in children is not familiar to pediatrician and pediatric surgeons. This report is to call for alertion of colorectal carcinoma in children, Methods Two cases of colonic adenocarcinomas were studied and literatures were reviewed.Results Histological diagnosis of both cases are poorly differentiated mucin-secreting adenocarcinomas. One died within a year and the other is still alive 6 months postoperatively with good health. In literatures, the common symptoms of colorectal carcinoma are vague abdominal pain, vomiting, alteration of bowel habits, rectal bleeding, anemia and weight loss, etc. Contrast studies, endoscopy, ultrasonography and CT are presently used procedures for diagnosis. Histologically, poorly differentiated mucin-secreting adenocarcinomas has been found in more than 50% of colorectal carcinoma in children, whereas in adults, the occurrence is only about 5%. The prognosis of colorectal carcinoma is considered quite poor. Only 1. 5% to 2.5% children with colorectal carcinoma survived 5 years or more after surgery in literatures. Conclusion Unlike adult colorectal carcinoma, the overall prognosis is poor. Delayed diagnosis, advanced stage of disease at presentation, and, most importantly, mucinous type of histology are the major factors of poor outcome in children. Early diagnosis and a combined treatment with surgery, chemotherapy and radiation may improve the prognosis.