Retrospective analysis of 79 gastrointestinal carcinoids diagnosed by endoscopy and review of literature / 解放军医学杂志

ABSTRACT

Objective To explore clinical manifestations, endoscopic and pathologic characteristics, and treatment of gastrointestinal carcinoids, thus improving diagnosis and treatment. Methods The clinical data of a total of 79 cases of gastrointestinal carcinoids discovered via endoscopy and diagnosed pathologically in General Hospital of People's Liberation Army from January 2007 to March 2011 were retrospectively analyzed, including clinical features, appearance in endoscopy, pathological diagnosis, treatment, occurrence of metastasis of the carcinoid, and treatment effects. Furthermore, a review of literature was conducted. Results Among the 79 patients with gastrointestinal carcinoids, those with stomach carcinoids accounted for 12.7% (10/79), duodenal carcinoids 11.4% (9/79), carcinoids of the sigmoid colon 1.3% (1/79), and rectal carcinoid 74.6% (59/79). There were no typical clinical manifestations in all of the 79 patients. Endoscopic findings were primarily polypoid or submucosal tumor. Up to 31 cases were diagnosed through pathological examination of biopsy specimens, whereas 48 cases were diagnosed after operative treatment. Immunohistochemistry was conducted in 41 specimens, and the results indicated that the positive rate of chromaffin granule A(CgA), synaptophysin(Syn), and CD56i was 34.1%, 100%, and 80.5%, respectively. A total of 62 patients were cured successfully under endoscopy. Furthermore, the metastasis rate was low (7.6%, 6/79). Conclusions There was no specific clinical manifestation in the early stage of the carcinoids, and gastrointestinal endoscopy and pathology were the main tools for their discovery and diagnosis. The treatment method for gastrointestinal carcinoid was dependent on the size of tumor, infiltration, and metastasis. Endoscopic treatment should be the first choice for patients who meet the criteria of endoscopic excision.