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目的分析直肠类癌的临床病理特征、外科治疗方法及其长期疗效。方法对1966年1月至2004年12月手术治疗的74例直肠类癌患者的临床资料进行回顾性分析,按照不同危险因素分组进行统计学分析,比较各组手术治疗效果和生存率。结果 1,3,5年累计生存率分别为98.9%、94.3%和89.2%,直肠类癌最大径≤2.0 cm组与最大径>2.0 cm组的生存比较差异有显著性(P<0.05);未侵犯肌层组与浸润肌层组的生存比较差异有显著性(P<0.05)。结论肿瘤大小和肌层浸润是决定直肠类癌手术方式的关键,也是影响预后的两个重要相关因素,肿瘤最大径>2 cm、肌层浸润的直肠类癌预后不良,应综合考虑采用个体化治疗方案。早期发现、早期诊断和根治性治疗是进一步提高患者生存率的关键。
Objective To analyze the clinicopathological features, surgical treatment and long-term efficacy of rectal carcinoids. Methods The clinical data of 74 patients with rectal carcinoid surgeries treated from January 1966 to December 2004 were retrospectively analyzed. The patients were divided into different groups according to different risk factors, and the operative effect and survival rate of each group were compared. Results The cumulative survival rates at 1, 3 and 5 years were 98.9%, 94.3% and 89.2% respectively. There was a significant difference in survival between maximal diameters> 2.0 cm and maximal diameters> 2.0 cm in rectal carcinoid tumors (P <0.05). There was a significant difference in survival between the non-invasive muscle group and the infiltrating myometrium group (P <0.05). Conclusions Tumor size and myometrial infiltration are the two key factors affecting the prognosis of rectal carcinoid tumors. The maximum diameter of tumor is more than 2 cm. The rectal carcinoid tumor with poor prognosis of myometrial invasion should be considered individually Treatment programs. Early detection, early diagnosis and radical treatment are the keys to further improve the survival rate of patients.