Ishikawa H, Imanishi K, Otani T, Okuda S, Tatsuta M, Ishiguro S
Department of Gastroenterology, Center for Adult Diseases, Osaka, Japan.
Endoscopy. 1989 May;21(3):133-5. doi: 10.1055/s-2007-1012922.
The effectiveness of endoscopic polypectomy in the treatment of carcinoid tumors of the rectum was investigated. Flat tumors of less than 1.5 cm in the largest diameter, of normal or yellow color, consisting histologically of solid nodular nests or trabecular or ribbon-like structures were "early" tumors, in which the tumor cells were confined to the mucosa and submucosa, and did not involve deeper layers. Eight patients with "early" carcinoids were treated by endoscopic polypectomy. Subsequently, two of them were submitted to surgery, while the other six were followed-up endoscopically. Histological examination of the specimens obtained at operation showed no evidence of residual tumor cells at the polypectomy site. Endoscopic follow-up studies also failed to reveal local recurrence in any of the patients during the average observation period of 1.3 years. The wall of the rectum was significantly thicker than that of the sigmoid colon, so that deeper local excision was possible. These findings indicate that even though "early" carcinoid tumors of the rectum showed submucosal invasion, they were completely cured by local endoscopic excision.
研究了内镜下息肉切除术治疗直肠类癌肿瘤的有效性。最大直径小于1.5 cm、颜色正常或呈黄色、组织学上由实性结节状巢或小梁状或带状结构组成的扁平肿瘤为“早期”肿瘤，其中肿瘤细胞局限于黏膜和黏膜下层，未累及更深层。8例“早期”类癌患者接受了内镜下息肉切除术。随后，其中2例接受了手术，另外6例接受了内镜随访。手术标本的组织学检查显示，息肉切除部位没有残留肿瘤细胞的迹象。内镜随访研究也未发现任何患者在平均1.3年的观察期内出现局部复发。直肠壁明显比乙状结肠壁厚，因此可以进行更深的局部切除。这些发现表明，尽管直肠“早期”类癌肿瘤显示有黏膜下浸润，但通过局部内镜切除可完全治愈。
