直肠类癌的诊断与治疗(附45例分析)

目的：探讨直肠类癌的诊断及治疗手段。方法：本文分析了45例直肠类癌的诊断要点，手术原则及手术方法。结果：45例病人中，39例得到随访，随访率86．6％，5年生存率43．8％。结论：直肠类癌症状无特殊性，诊断不易。＞40岁有直肠肛管症状者应想到本病的可能，并作常规肛指检查。有怀疑者应行病理组织检查，必要时切片作免疫组化染色以提高诊断率，手术应结合病变大小，浸润深度，个体化治疗。对于有肝转移应力急同时切除原发灶和转移灶，其他类型的治疗（如化疗）可能会对延长病人的生存期有一定作用。

Diagnosis and treatment of carcinoid tumor of rectum :analysis of 45 cases.

Objective To investigate the diagnosis and management of carcinoid tumor in rectum.Methods Forty five cases of carcinoid tumor of rectum,the essentials of their diagnosis,and the pricinples and methods of operation were discussed and analyzed retrospectively.Results Of these cases,39 were followed up (86.6%) and the 5 year survival rate was 43.8%.Conclusion There were no special symptoms in carcinoid tumor of rectum,and it was difficult to make its diagnosis.We should think about the possibility of the carcinoid tumor of rectum even in the patients above 40 years old with the symptoms of rectum and anus.Routine finger rectum examination should be done in this kind of patients,and in case of suspicion,the pathologic examination should be done.If necessary,pathologic immunochemical stain should be used to increase the diagnostic rate.Surgical operation should be individualized,taking the size and invasion of tumor into consideration.If accompanied with hepatic metastasis,the primary tumor and hepatic metastatic tumors should be resected simultanously with efforts.Other kinds of treatment such as chemotherapy may help the patients with carcinoid tumor of rectum to prolong their survival period.