Analysis Of43Cases Of Digestive System Carcinoids

Objective:To improve the level of recognition, diagnosis and treatment byanalyzing the clinical data of digestive system carcinoids.Methods:The data of43cases of digestive system carcinoids which werehospitalized during Jan1991and Jan2012were analysed retrospectively. According tothe diameter of tumor and depth of invasion respectively,43cases were divided intothree groups. All datas were analyzed by SPSS17.0package to discuss the relation ofdiameter, invasion with metastasis of carcinoid.Results:In our results, their ages ranged from20to80years old and the averageage was48.7. The interval from onset to be diagnosed was from1hour to10years,with10.2months as average. The rectum was the most common site of carcinoids in20cases (46.5%), followed by the appendix in9（20.9%) and the stomach in5(11.6%),then ileum, colon and pancreas in2in each was4.7%respectively, and esophagus,duodenum and gall bladder in1in each was2.3%respectively. Without specialclinical manifestation, abdominal pain(62.8%), bleeding of gastrointestinaltract(23.3%), diarrhea(20.9%), nausea and vomiting (18.6%) were the most commonsymptoms. The serum levels of CEA, AFP and CA199were detected in38cases, inwhich only1had elevated CA199level. Primary lesion or metastasis was detected in4cases by type-B ultrasonic,1by X-ray barium,4by CT,1by MRI and1by ECT.Endoscopy was performed in30cases in which positive findings were detected.26cases got final diagnosis per endoscopy and biopsy in28, the confirmed diagnosis rateof endoscopic biopsy was92.9%.17cases were diagnosised by operation and biopsy.There was no significant difference in metastasis of carcinoid among the group of1.0to2.0cm in diameter and the group of≤1.0cm, and the group of>2.0cm(P>0.05), butthere was significant difference between the group of≤1.0cm and the group of>2.0cm(P<0.05). There was no significant difference in metastasis of carcinoid amongmuscularis and submucosa, serosa(P>0.05), but there was significant difference between submucosa and serosa(P<0.05).13cases were taken endoscopic resection,followed by additional surgery in11cases, and pathological specimens of additionalsurgery were positive in2cases. The success rate of endoscopic resection was84.6%.The remaining30cases prefered surgical resection and5out of them receivedsystemic chemotherapy.Conclusions:The rectum is the most common site of carcinoids. The clinicalmanifestations of gastrointestinal tract carcinoids are non-specific and they aremisdiagnosed easily. Endoscopic and surgical biopsy is an important method todiagnose. Metastasis possibility increases with the aggrandizement of the diameter andthe deepening of invasion level. Surgical resection is preferred in treating carcinoidtumor and some may be cured by endoscope. when necessary, comprehensivetreatment of combining chemotherapy, medical treatment, etc, may be taken.