| 特集名 | 消化器神経内分泌腫瘍 | |
|---|---|---|
| 題名 | 大腸神経内分泌腫瘍 | |
| 発刊年月 | 2013年 01月 | |
| 著者 | 松田 圭二 | 帝京大学医学部外科 |
| 著者 | 端山 軍 | 帝京大学医学部外科 |
| 著者 | 山田 英樹 | 帝京大学医学部外科 |
| 著者 | 石原 聡一郎 | 帝京大学医学部外科 |
| 著者 | 野澤 慶次郎 | 帝京大学医学部外科 |
| 著者 | 橋口 陽二郎 | 帝京大学医学部外科 |
| 【 要旨 】 | 大腸神経内分泌腫瘍は，カルチノイドと内分泌細胞癌に分けられる． カルチノイドは，大きさ10mm以下の病変では内視鏡的摘除術や局所切除術の適応である．大きさ10〜20mmの病変は，結腸〜Raであれば腹腔鏡（補助）下手術を行う．肛門管やRb下部に位置する場合，局所切除で経過観察とするか根治術（人工肛門作製）を行うか，慎重に判断する．大きさが20mm以上やMP以深に対しては，根治術を行う．カルチノイドは癌との合併に注意する． 一方，内分泌細胞癌は細胞増殖能や転移率が高い腫瘍であり，1年生存率が10〜15％と予後はきわめて不良である．手術治療だけでは限界があり，化学療法や放射線治療などの有効なレジメンの確立が望まれる． |
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| Theme | Gastroenteropancreatic Neuroendocrine Tumors | |
|---|---|---|
| Title | Neuroendocrine Tumors in Colon and Rectum | |
| Author | Keiji Matsuda | The Department of Surgery, Teikyo University School of Medicine |
| Author | Tamuro Hayama | The Department of Surgery, Teikyo University School of Medicine |
| Author | Hideki Yamada | The Department of Surgery, Teikyo University School of Medicine |
| Author | Soichiro Ishihara | The Department of Surgery, Teikyo University School of Medicine |
| Author | Keijiro Nozawa | The Department of Surgery, Teikyo University School of Medicine |
| Author | Yojiro Hashiguchi | The Department of Surgery, Teikyo University School of Medicine |
| [ Summary ] | Neuroendocrine tumors in the colon and rectum are divided into two groups, carcinoid tumors and endocrine cell carcinomas (ECC). If the size of the carcinoid is 10 mm or under, endoscopic resection or local excision is appropriate. If it is from 11 to 20 mm and if located in the colon, RS or Ra, laparoscopicassisted surgery is appropriate. However, if it is located in the Rb or anal canal, the choice should be made carefully as to whether local resection or radical surgery to create a permanent colostomy should be performed. If the tumor is larger than 20 mm, or if it has invaded the muscularis propriae, radical surgery is required. For patients at increased risk of synchronous cancers, those with carcinoid tumors should undergo appropriate screening and surveillance. ECC displays highly proliferative activity and a high degree of metastases. The one-year survival rate for these cases is 10 to 15 %, which indicates very poor prognoses. Because surgical therapy has limited uses, effective chemotherapy regimens or radiotherapy are required. |
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