Résumé
Background:Gastrointestinal carcinoids are prone to be neglected in clinical practice because of the poor specific symptoms in early stage. Aims:To analyze the clinicopathological characteristics,treatment modalities and prognosis of a series of cases of gastrointestinal carcinoids for strengthening the understanding of the disease. Methods:A total of 116 patients diagnosed as gastrointestinal carcinoids by pathology from Jan. 1997 to Jan. 2010 in 8 hospitals at Wuhan were enrolled in this retrospective study. Data on sex,age,major symptoms,diagnostic approaches,treatment modalities, pathological features and prognosis, etc. were collected and analyzed. Results:The most common sites of the gastrointestinal carcinoids were rectum(59. 5%)and stomach(19. 8%);the most common symptoms were abdominal pain,abdominal distention and hematochezia. The positivity rates of immunohistochemical marker NSE,Syn and CgA were 92. 7%,87. 5% and 62. 5%,respectively. The proportion of stomach carcinoids with diameter larger than 2 cm was 73. 9%, and that of rectal carcinoids was only 13. 0%(P 0. 05). Conclusions:Gastrointestinal carcinoids enrolled in this study distributed mainly in rectum and stomach. As compared with rectal carcinoids,gastric carcinoids were more advanced in disease stage with poorer prognosis. Regular health checks, strengthening the understanding of the disease,and grasping the specificities of carcinoids distributed at different sites might be helpful for the early diagnosis and treatment of gastrointestinal carcinoids,thus improving the survival rate.
Résumé
Objective To investigate the clinical and pathological features of anorectal malignant melanoma ( AMM) .Methods The clinical pathological and follow-up data of 7 cases of anorectal malignant melanoma were collected.The clinical and histopathological features and immunophenotype were analyzed .Results Among the 7 cases, 5 cases were female, 2 cases were male, aged 50-68 years, the average was 61 years.The tumors located in the lower rectum in 1 cases, 2 cases of teeth near the line , 4 cases of anal anus .The structure and morphology of the cancer cells were diverse .The organizational structures were mainly diffuse , focal and acinar .The cellular morphologies were mainly epithelioid , spindle and lymphocyte like .And the results of IHC showed the expression of the following three markers, vimentin, S-100 and HMB45, were strongly positive in cancer cells.However, the expression of CK , EMA and LCA were negative .And 2 cases of CEA expression were positive , LI Ki-67 was 20%-50%.Conclusions Anorectal malignant melanoma is one kind of rare malignant tumor and its characteristic morphology , immunophenotype could be helpful for diagnosis and differential diagnosis .