カルチノイド・内分泌細胞癌―臨床の立場から

Carcinoid, Neuroendocrine Carcinoma─From the Clinical Viewpoint

要旨　当院における胃・十二指腸カルチノイドの治療成績を検討した．胃では15例中4例にリンパ節転移を認め，3mm大および20mm大のRindi分類Type III，100個以上病変を認めたRindi分類Type Iおよび15mm大のRindi分類不明の病変であった．十二指腸では10例中2例にリンパ節転移を認め，それぞれ6mm大および8mm大で下行部の病変であった．深達度は全例が粘膜下層に限局していた．内視鏡的治療の適応は粘膜下層までに限局した病変で画像検査上リンパ節転移がなく，胃では10mm以下の少数のRindi分類Type I病変，十二指腸では球部の10mm以下が適応と考えるが，5mm以上ではリンパ節転移の可能性を否定しえないと考える．

　We analyzed our cases of carcinoids of stomach and duodenum. Four cases out of fifteen cases of gastric carcinoids had lymph node metastasis : Type III carcinoid, 3mm in size ; Type III carcinoid, 22mm in size ; Type I multiple（more than 100）carcinoids ; unkown Rindi's Type, 15mm in size. Two cases out of 10 cases of duodenal carcinoids had lymph node metastasis, which were located in 2nd portion and 6mm and 8mm in size respectively. All carcinoids were limited within submucosa. Endoscopic excision seems to be indicated in the following lesion without lymph node metastasis and limiting within submucosa : gastric carcinoid which is 10mm or less in size, duodenal carcinoid which is located in the 1st portion and is 10mm or less in size. However, lesion more than 5mm in size may have lymph node metastasis which is not recognized.