Berner M
Service de chirurgie, CHUV, Lausanne.
Schweiz Med Wochenschr. 1993 Apr 3;123(13):594-9.
270 digestive carcinoid tumors have been diagnosed at the Pathology Institute of Lausanne between 1971 and 1990; of these 21 were associated with other, synchronous, tumors: 7 of the carcinoids were from the appendix (33%), 8 from the small bowel (38%), 4 were from the colorectum (25%), one from the duodenum (4.5%) and finally one from the stomach (4.5%). Two thirds (14) were associated with adenocarcinomas of the colon, the rest with 2 gastric tumors, 1 tumor of the appendix, 1 of the gallbladder, 1 of the small gut, 1 of the duodenum and 1 of the peritoneum. The mean age of the patients was 70 years, which correlates with the large proportion of carcinomas of the colon. The males (16) clearly outnumbered the females (5) for no obvious reason. 80% of the carcinoids were discovered during the treatment of the associated tumor. Survival was directly related to the stage and aggressivity of the malignant tumor. The carcinoid itself hardly changed the prognosis, except for one case of liver failure due to metastases from carcinoid of the stomach associated with an adenocarcinoma. The histologic features of the carcinoid tumors were unexceptional. Different hypotheses to explain the associations are formulated.
1971年至1990年间,洛桑病理研究所诊断出270例消化类类癌肿瘤;其中21例与其他同期肿瘤相关:7例类癌来自阑尾(33%),8例来自小肠(38%),4例来自结直肠(25%),1例来自十二指肠(4.5%),最后1例来自胃(4.5%)。三分之二(14例)与结肠癌相关,其余与2例胃肿瘤、1例阑尾肿瘤、1例胆囊肿瘤、1例小肠肿瘤、1例十二指肠肿瘤和1例腹膜肿瘤相关。患者的平均年龄为70岁,这与结肠癌的高比例相关。男性(16例)明显多于女性(5例),原因不明。80%的类癌是在相关肿瘤治疗期间发现的。生存率与恶性肿瘤的分期和侵袭性直接相关。类癌本身几乎不影响预后,除了1例因胃类癌转移合并腺癌导致肝功能衰竭的病例。类癌肿瘤的组织学特征并无异常。文中提出了不同的假说来解释这些关联。