Wang Andrew Y, Ahmad Nuzhat A
Gastroenterology Division, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Curr Opin Gastroenterol. 2006 Sep;22(5):529-35. doi: 10.1097/01.mog.0000239868.27328.1d.
To provide an updated review of the diagnosis, management, and treatment of rectal carcinoid tumors, with special emphasis on minimally invasive surgical techniques to treat localized disease.
Carcinoids are morphologically and biologically heterogeneous neuroendocrine tumors that have malignant potential, and are most commonly found in the gastrointestinal tract. The incidence of all carcinoids appears to be increasing, which may reflect improved diagnostic modalities. The rectum is the third most common location for gastrointestinal carcinoids. Recent data have suggested that rectal carcinoids are over-represented in Black and Asian populations. The survival rate for patients with rectal carcinoids is superior to that of carcinoids found elsewhere in the gastrointestinal tract. Tumor size in rectal carcinoids is predictive of metastasis and can reliably guide management. Review of recent literature demonstrates good evidence that localized rectal carcinoids are amenable to local resection.
With widespread colorectal cancer screening, heightened awareness, and improved diagnostic modalities, the incidence of rectal carcinoids should continue to increase. There is evidence that convincingly demonstrates that patients with rectal carcinoids less than 2 cm in diameter, localized to the mucosa or submucosa, may be safely and effectively removed via minimally invasive resection.
提供关于直肠类癌肿瘤诊断、管理和治疗的最新综述，特别强调治疗局限性疾病的微创外科技术。
类癌是具有恶性潜能的形态学和生物学异质性神经内分泌肿瘤，最常见于胃肠道。所有类癌的发病率似乎都在上升，这可能反映了诊断方式的改进。直肠是胃肠道类癌的第三大常见发病部位。最近的数据表明，黑人和亚洲人群中直肠类癌的比例过高。直肠类癌患者的生存率高于胃肠道其他部位发现的类癌。直肠类癌的肿瘤大小可预测转移，并能可靠地指导治疗。对近期文献的回顾表明，有充分证据表明局限性直肠类癌适合局部切除。
随着广泛的结直肠癌筛查、意识提高和诊断方式改进，直肠类癌的发病率应会继续上升。有证据令人信服地表明，直径小于2厘米、局限于黏膜或黏膜下层的直肠类癌患者，可通过微创切除安全有效地切除。
