【摘要】 目的探讨消化道神经内分泌癌生长过程中的生长模式,寻找不同生长模式与治疗方案选择的关系。方法将病例分为微肿瘤组和对照组两组。综合分析消化道神经内分泌癌肿瘤病灶的包膜有无、生长方式、脉管浸润、大体分型及其病理学的特征,应用统计学方法进行比较研究。结果(1)微肿瘤组包膜完整者占75.0%,对照组包膜完整者占0%,有包膜但不完整者4例,两组比较差异有统计学意义(P<0.01)。(2)微肿瘤组大体分型均为轻微隆起型,对照组可出现轻微隆起型、BormmannⅠ型、Ⅱ型、Ⅰ型+Ⅱ型,而Ⅲ型、Ⅳ型较为少见。(3)微肿瘤组的肿瘤灶的生长模式多为膨胀性生长模式,而对照组的生长模式为浸润性生长模式,<10mm的早期癌灶生长模式可见前方(深部)浸润倾向,而更大的癌灶其生长模式为前方和侧方均表现为浸润性生长模式。(4)微肿瘤组的癌灶脉管浸润占0%,对照组为88.9%,两组比较差异有统计学意义(P<0.01)。(5)微肿瘤组的淋巴转移发生率为0%,对照组为72.2%,两组比较差异有统计学意义(P<0.01)。(6)微肿瘤组的癌灶可内镜下切除治疗。结论消化道神经内分泌癌的微肿瘤灶具有独特的生长模式,认识其生长模式,有助于治疗方案的选择。微肿瘤组的癌灶可内镜下切除治疗。更多还原

【Abstract】 Objective To observe the growth pattern of neuroendocrine cancers in gastrointestinal tract. Methods Out of 40 cases of neuroendocrine cancer there were 4 cases with minute carcinoid and 36 without (control group). The envelope, growth pattern, blood vessel and lymphatic invasion, pathological characteristics were analyzed. Results The rate of intact envelope in minute carcinoids group was 75.0%, whereas that was 0% in control group(P<0.01). Macroscopic appearance of minute carcinoids was slightly protruded while for control group most was Bormmann’s Ⅰ, Ⅱ and Ⅰ+Ⅱ type; Bormmann’s Ⅲ and Ⅳ types were rare. The most common growth pattern of minute carcinoids was bulged while it was invasive pattern in control group. If the size of the tumors was less than 10 mm, it appeared deeper invasive pattern whereas the larger tumors showed deeper and lateral invasive pattern. No case in minute carcinoid group had blood vessel and lymphatic vessel invasion, it was 88.9% in control group (P<0.01). No case in minute carcinoid group had lymph node metastasis, it was 72.2% in control group (P<0.01). Conclusion Minute carcinoids possess unique characteristics of growth pattern, which can be treated by endoscopic resection.更多还原