Clinical Analysis Of Carcinoid Tumors In Digestive Tract:A Report Of 71 Cases

Objective: In order to come up with a theory for clinical diagnosis and treatment of digestive tract carcinoid tumours, this dissertation analyzes statistically the clinical symptoms, diagnosis,treatment and prognosis of digestive tract carcinoid tumours.Besides, it discusses the clinical features, effectively diagnostic method and treatment of digestive tract carcinoid tumours.Method:This dissertation studies retrospectively the clinical data of 71 cases of digestive tract carcinoid tumours patients who were treated in China-Japan Union Hospital of Jilin University between January 2010 and December 2015. The data include the patients’ general information, clinical symptoms, diagnosis impression, laboratory examination results, endoscopy results,imaging findings, pathological examination results,immunohistochemical results, treatment and prognosis, etc, which are analyzed statistically by SPSS 18.0.Result:The cases include 42 male patients and 29 female patients(the proportion is 1.45: 1), and the average age is 49.03(ranged from 23-75). The course of disease is from 1 day to 2years, with a median duration of 7 months. The most common disease location is rectum(62 cases), including 5 cases of stomach,3 cases of appendix, 1 case of sigmoid. The major clinical manifestation of digestive tract carcinoid tumours include:abdominal pain(29 cases), followed by changing in bowel habits(24 cases), abdominal distension(7 cases), and no obvious symptom(18 cases). There was not carcinoid syn drome in this study. In the group of 71 cases, the endoscopic check and endoscopic biopsy were operated to 68 patients, other than 3cases of appendiceal carcinoid tumors. More specifically, 41 cases got the positive findings by the endoscopic biopsy. The rate of accuracy of endoscopic biopsy is 60.29%. The biggest positive rate can be seen in Syn and Ki67 in the immunohistochemical examine,91.67% and 88.24% respectively.Treatment:34 patients were treated by endoscopic resection(EMRC in 12 cases of rectal carcinoid, in 21 cases of rectal carcinoid, and in 1 case of gastric carcinoid); 36 patients were treated by surgery resection(TEM in22 cases of rectal carcinoid, radical operation in 6 cases of rectal carcinord, Billroth II gastrectomy in 3 cases of gastric carcinoid,total gastrectomy in 1case of gastric carcinoid, appendectomy in 3 cases of appendiceal carcinoid, sigmoidectomy and lymph node dissection in 1 case of sigmoid carcinoid); 1 patient was not treated.68 patients in this study were followed up,3 cases of rectal carcinoid lost,the follow-up rate was 95.77%. No patients were dead until December 2015. The time range of follow-up is from 4months to 69 months, with 29 months as median. One patient with rectal carcinoid palindromia 14 months after operation in the primary site,treated by radical operation.Conclusion:Typical clinical symptoms can not be observed in digestive tract carcinoid, and the major symptoms are abdominal pain and changing in bowel habits(including diarrhea, shapeless defecate and astriction). The endoscopy and endoscopic biopsy are main examine method of diagnose. The pathological examination and immunohistochemical analysis are gold standard to diagnose. And the endoscopic resection and surgery are major treatment methods.