112例直肠神经内分泌瘤的内镜下治疗及预后分析

陈瑶; 代剑华; 冯晓峰; 吴宏博; 栾兆辉; 彭贵勇

doi:10.16016/j.1000-5404.202008158

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112例直肠神经内分泌瘤的内镜下治疗及预后分析

临床医学 | 更新时间：2026-01-09

- 112例直肠神经内分泌瘤的内镜下治疗及预后分析
- Endoscopic diagnosis and treatment of rectal neuroendocrine tumors and analysis of prognosis: report of 112 cases
- 第三军医大学学报 2021年43卷第4期页码：342-346
- 作者机构：
  
  400038 重庆，陆军军医大学第一附属医院消化科
- 作者简介：
  
  [ 彭贵勇，E-mail：pgy63@163.com PENG Guiyong, E-mail:pgy63@163.com
- 基金信息：
- DOI：10.16016/j.1000-5404.202008158
  中图分类号： R181.32;R730.264;R735.37
- 收稿：2020-08-20，
  
  修回：2020-11-24，
  
  纸质出版：2021-02-28
- 稿件说明：
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陈瑶, 代剑华, 冯晓峰, 等. 112例直肠神经内分泌瘤的内镜下治疗及预后分析[J]. 第三军医大学学报, 2021,43(4):342-346.

Yao CHEN, Jianhua DAI, Xiaofeng FENG, et al. Endoscopic diagnosis and treatment of rectal neuroendocrine tumors and analysis of prognosis: report of 112 cases[J]. Journal of Third Military Medical University, 2021, 43(4): 342-346.
陈瑶, 代剑华, 冯晓峰, 等. 112例直肠神经内分泌瘤的内镜下治疗及预后分析[J]. 第三军医大学学报, 2021,43(4):342-346. DOI： 10.16016/j.1000-5404.202008158.

Yao CHEN, Jianhua DAI, Xiaofeng FENG, et al. Endoscopic diagnosis and treatment of rectal neuroendocrine tumors and analysis of prognosis: report of 112 cases[J]. Journal of Third Military Medical University, 2021, 43(4): 342-346. DOI： 10.16016/j.1000-5404.202008158.

摘要

目的

评估内镜诊治直肠神经内分泌瘤的价值。

方法

回顾性分析2011-2019年在我院行内镜下切除的112例直肠神经内分泌瘤资料，分析其临床表现、白光和超声内镜表现、内镜下治疗、术后并发症、术后病理结果、随访及预后等。

结果

内镜下切除治疗直肠神经内分泌瘤共112例。白光表现有8例表现为息肉样外观，其他均表现为黏膜下隆起。术前超声肠镜检查来源于黏膜层、黏膜下层、黏膜及黏膜下层、固有肌层分别占7.5%(7例)、72.0%(67例)、18.3%(17例)、2.1%(2例)。术中2例出现固有肌层损伤，行钛夹及尼龙圈荷包缝合治愈。术后4例出现迟发性出血，均行内镜下止血治愈。术后病理提示G1期和G2期分别占106例、6例。9例术后提示切缘阳性，余均内镜完整切除。随访至今1例局部复发，再次内镜下切除。平均随访(49.4±25.3)个月，均存活良好。

结论

直肠小于1 cm的神经内分泌瘤绝大多数是G1期，内镜下切除直肠神经内分泌瘤安全有效，预后良好。

Abstract

Objective

To access the value of endoscopy in the diagnosis and treatment of rectal neuroendocrine tumors (NET).

Methods

A total of 112 rectal NET patients undergoing endoscopic resection in our hospital from 2011 to 2019 were enrolled in this retrospective study. Clinical manifestations

white light and endoscopic ultrasound (EUS) findings

endoscopic procedures

post-operative complications and pathological outcomes

follow-up data and prognosis were enrolled and analyzed.

Results

All of the 112 NETs were resected by endoscopy successfully. Among them

8 NETs showed polypoid-like and the others appeared as submucosal tumor under white light. The results of EUS indicated that the origin of the tumors were mucosa (7

7.5%)

submucosa (67

72.0%)

mucosa and submucosa combined (17

18.3%)

and muscularis propria (2

2.1%). During the endocopic dissection

muscularis propria damage occurred in 2 cases

and they were cured through clips and purse string suture. Delayed hemorrhage were observed in 4 cases

and were cured with endoscopic technique such as hot forceps. Pathological outcomes displayed that there were 106 cases of grade G1 and 6 cases of grade G2. Complete resection were achieved in 103 subjects

while 9 subjects had positive resection margins. All subjects were followed up till now

and only one of them experienced local relapse and underwent second endoscopic mucosal dissection. During the mean follow-up time of 49.4±25.3 months

all survived well.

Conclusion

Most of NET less than 1 cm in size are in grade G1. The tumor can be resected by endoscopy safely and effectively

and has favorable prognosis.

关键词

Keywords

references

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