胃肠道肉瘤样癌的诊治:附5例报告

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目的:探讨胃肠道肉瘤样癌的临床特点和诊治经验,分析其预后因素。方法:回顾性分析8年间收治的5例胃肠道肉瘤样癌患者的临床特点、病理、术后随访资料,并复习相关文献。结果:全组肉瘤样癌发生于胃、直肠各1例,空肠3例,男女之比2:3;临床以腹痛、腹胀、消瘦、大便潜血、贫血、腹部肿块、肠穿孔等症状为主要表现;术前诊断率为40.0%,2年存活率为40.0%(2/5),3年存活率为零;淋巴结转移多见,其预后生存率较低。结论:胃肠道肉瘤样癌发现晚、术前诊断率低,需B超、CT、消化内镜、病理活检、免疫组化及必要的剖腹探查有助于诊断;手术切除是其主要治疗手段,肿瘤切除术后预后仍不乐观。 Objective: To investigate the clinical features and diagnosis and treatment of gastrointestinal sarcomatoid carcinoma and analyze its prognostic factors. Methods: The clinical features, pathology, postoperative follow-up data of 5 patients with gastrointestinal sarcomatoid carcinoma treated in 8 years were analyzed retrospectively. The related literatures were reviewed. Results: The whole group of sarcomatoid carcinoma occurred in the stomach and rectum in 1 case, jejunum in 3 cases, the ratio of men to women was 2: 3. The clinical manifestations included abdominal pain, abdominal distension, weight loss, fecal occult blood, anemia, abdominal mass and intestinal perforation ; The preoperative diagnosis rate was 40.0%; the 2-year survival rate was 40.0% (2/5); the 3-year survival rate was zero; lymph node metastasis was common and the prognosis survival rate was low. Conclusions: Gastrointestinal sarcomatoid carcinomas were found to be late and preoperatively diagnosed at low rates, requiring B-mode ultrasound, CT, digestive endoscopy, biopsy, immunohistochemistry and necessary laparotomy to diagnose them. Surgical resection is the main treatment , The prognosis after tumor resection is still not optimistic.
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