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[1例新辅助化疗后经腹腔镜辅助括约肌间切除术治疗的直肠内分泌细胞癌]

[A case of rectal endocrine cell carcinoma treated by laparoscopic assisted intersphincteric resection after neoadjuvant chemotherapy].

作者信息

Wakatsuki Kazuo, Yoshioka Shigeru, Shiobara Masayuki, Kataoka Masaaki, Arai Shuka, Tonooka Toru, Miyazawa Koutaro, Oeda Yoshio

机构信息

Dept. of Surgery, Chiba Municipal Kaihin Hospital.

出版信息

Gan To Kagaku Ryoho. 2013 Nov;40(12):2026-8.

Abstract

A 51-year-old male patient visited our hospital with a complaint of anal dysfunction and anal pain. Colonoscopy revealed a lower rectal cancer just above the dentate line, and its biopsy showed endocrine cell carcinoma. Enhanced computed tomography( CT) showed pararectal and right inguinal lymph node metastasis. Leucovorin, 5-fluorouracil, and oxaliplatin (FOLFOX) therapy was initiated first; then, after K-RAS was found to be wild type, 6 courses of FOLFOX plus panitumumab were administered. After the chemotherapy, the main tumor and the lymph node swelling reduced evidently. Its effect was judged as a partial response (PR). Laparoscopic assisted intersphincteric resection, right inguinal lymph node dissection, and temporary ileostomy were performed. The pathology revealed endocrine cell carcinoma (MP, ly2, v2, n0, stage II). Its pathological effect was judged as Grade 1b. Five months after the surgery, the ileostomy was closed.

摘要

一名51岁男性患者因肛门功能障碍和肛门疼痛前来我院就诊。结肠镜检查发现齿状线以上低位直肠癌,活检显示为内分泌细胞癌。增强计算机断层扫描(CT)显示直肠旁和右腹股沟淋巴结转移。首先开始使用亚叶酸钙、5-氟尿嘧啶和奥沙利铂(FOLFOX)治疗;然后,在发现K-RAS为野生型后,给予6个疗程的FOLFOX加帕尼单抗治疗。化疗后,主要肿瘤和淋巴结肿大明显减轻。其疗效判定为部分缓解(PR)。进行了腹腔镜辅助括约肌间切除术、右腹股沟淋巴结清扫术和临时回肠造口术。病理显示为内分泌细胞癌(MP,ly2,v2,n0,II期)。其病理疗效判定为1b级。术后5个月,回肠造口关闭。

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