Lee Sang Pyo, Sung In-Kyung, Kim Jeong Hwan, Lee Sun-Young, Park Hyung Seok, Shim Chan Sup
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2014 Apr;29(4):512-8. doi: 10.3346/jkms.2014.29.4.512. Epub 2014 Apr 1.
Biopsy of rectal carcinoid tumor is commonly taken before endoscopic resection. However the preceding biopsy can inhibit complete resection by causing blurred tumor border and fibrosis of the tissue. The objective of the study was to investigate the effect of preceding biopsy on complete endoscopic resection in rectal carcinoid tumor. It was also determined if rectal carcinoid tumors can be macroscopically distinguished by endoscopy. We reviewed retrospectively the records of patients with rectal carcinoid tumor who had undergone an endoscopic treatment at our hospital, during a 7-yr period. The resection margin was clear in 57 of 98 cases. The preceding biopsy was taken in 57 cases and the biopsy was significantly associated with the risk of incomplete tumor resection (OR, 3.696; 95% CI, 1.528-8.938, P = 0.004). In 95.9% of the cases, it was possible to suspect a carcinoid tumor by macroscopic appearance during initial endoscopy. The preceding biopsy may disturb complete resection of rectal carcinoid tumor. In most cases, the carcinoid tumor could be suspected by macroscopic appearance. Therefore the preceding biopsy is not essential, and it may be avoided for the complete resection.
直肠类癌肿瘤活检通常在内镜切除术前进行。然而,先前的活检可能会导致肿瘤边界模糊和组织纤维化,从而妨碍完整切除。本研究的目的是探讨先前活检对直肠类癌肿瘤内镜完整切除的影响。研究还确定了直肠类癌肿瘤是否可通过内镜进行宏观鉴别。我们回顾性分析了我院7年间接受内镜治疗的直肠类癌肿瘤患者的记录。98例患者中,57例切缘清晰。57例患者进行了先前活检,活检与肿瘤切除不完全的风险显著相关(比值比,3.696;95%可信区间,1.528 - 8.938,P = 0.004)。在95.9%的病例中,初次内镜检查时通过宏观表现有可能怀疑为类癌肿瘤。先前的活检可能会干扰直肠类癌肿瘤的完整切除。在大多数情况下,通过宏观表现可怀疑为类癌肿瘤。因此,先前的活检并非必要,为实现完整切除可避免进行活检。