消化道类癌的内镜特征和治疗

背景：近年来消化道类癌的检出呈上升趋势，正确认识其内镜特征并选择合理的治疗措施具有重要意义。目的：探讨内镜在消化道类癌诊治中的应用价值。方法：2005年1月～2011年8月于淮北市人民医院行局部内镜切除术的21例消化道类癌患者纳入研究，回顾性分析其内镜特征、治疗和预后情况。结果：本组患者以直肠类癌最为多见（14例），多位于低位直肠；胃类癌多位于胃体大弯，1例十二指肠类癌位于球部前壁。多数消化道类癌呈半球形隆起，表面光滑，分布网状毛细血管，球部类癌中央稍凹陷。12例患者行内镜黏膜切除术（EMR），8例行内镜黏膜下剥离术（ESD），1例行高频电切术。20例患者病变完整切除，随访期内未见复发。结论：内镜检查是诊断消化道类癌的重要手段。对于未超过黏膜下层的小的消化道类癌，EMR和ESD是可靠的治疗选择。

Endoscopic Characteristics and Therapeutics of Gastrointestinal Carcinoids

Background:The detection rate of gastrointestinal carcinoids shows an upward trend in recent years,the understanding of its endoscopic characteristics and the choice of reasonable therapeutic approach are of great importance.Aims: To investigate the application value of endoscopy in the diagnosis and treatment of gastrointestinal carcinoids.Methods: Twenty-one gastrointestinal carcinoid patients undergone local endoscopic excision from Jan.2005 to Aug.2011 at Huaibei People’s Hospital were enrolled in this study.The endoscopic characteristics,therapeutics and prognosis were analyzed retrospectively.Results: Rectal carcinoids were most common in this study(14 cases) and predominantly located in lower rectum;gastric carcinoids were mainly located in greater curvature at the gastric body,and one duodenal carcinoid was found in the anterior wall of duodenal bulb.Most of the carcinoids presented as a smooth hemispherical bulge covered with reticular capillaries,and the bulb carcinoid showed a bit of central depression additionally.Twelve patients received endoscopic mucosal resection(EMR),8 received endoscopic submucosal dissection(ESD),and one was given high frequency electrotomy.Twenty patients had their lesions completely resected,and no relapse was observed during follow up.Conclusions:Endoscopy is critical for the detection of gastrointestinal carcinoids.Small carcinoid not exceeding the submucosa can be removed reliably by EMR or ESD.