colorectal carcinoid
Introduction
Introduction to colorectal cancer Carcinoid, also known as argyrophiloma, occurs in the argyrophilic cells of the intestinal mucosa (Kulchitsky cells), which are chromaffic. Because it occurs from the lower part of the mucosa, it extends to the submucosal at an early stage and has been attributed to submucosal tumors. The disease is a rare low-grade malignant tumor, mostly local invasive growth with little metastasis. Carcinoids occur in the appendix, small intestine, rectum, stomach, duodenum and small intestine diverticulum. basic knowledge The proportion of illness: 0.0055% Susceptible people: no specific population Mode of infection: non-infectious Complications: colon polyps
Cause
Colorectal carcinogenesis
The cause is unknown. It has been reported that colorectal polyps, inflammatory bowel disease, and the incidence of colorectal cancer after cholecystectomy increase. Other studies suggest that it is related to genetic factors and eating habits.
Prevention
Colorectal cancer prevention
1, diet adjustment
Although colorectal cancer has a certain genetic predisposition, most of the sporadic colorectal cancer is closely related to environmental factors, especially dietary factors. Dietary intervention can reduce the incidence of colorectal cancer.
1 Energy intake Energy intake is associated with colorectal cancer. Most studies have shown that total energy intake is associated with the risk of colorectal cancer, whether it is protein, fat or carbohydrate. Reducing energy intake may reduce the incidence of colorectal cancer.
2 The occurrence of fat and red meat colorectal cancer is closely related to animal fat and meat. Studies have shown that women with high fat injection have a 32% increased risk of colorectal cancer compared with low-fat women. The intake of red meat in meat is a strong risk factor for colorectal cancer. Reducing the amount of fat in the food, especially if you try to eat less brown meat after roasting, can help the occurrence of colorectal cancer.
3 fruits, vegetables and dietary fiber cellulose can increase the amount of feces, dilute the carcinogen in the colon, and adsorb bile salts, which can reduce the incidence of colorectal cancer. Therefore, in the usual diet, you should eat as much vegetables, fruits, and cellulose as possible, and eat properly to reduce the incidence of colorectal cancer.
4 vitamins and trace elements have been shown that vitamin A, C, E can make colonic epithelial hyperplasia of adenoma patients into normal, but the current data does not support the use of antioxidant vitamins to prevent colorectal cancer. The relationship between trace elements and colorectal cancer is not yet detailed. Folic acid can reduce the incidence of colorectal cancer, but the specific mechanism is not clear.
5 Dietary anti-carcinogen diet of garlic, onion, leeks, sulphate contained in sucrose; citrus contains scorpion; grape, strawberry, apple plant phenol and carrot, yam, carotene contained in watermelon Both are thought to be able to inhibit mutations and have anticancer effects. Especially for garlic, studies have shown that garlic is the vegetable with the strongest protective effect and frees people from distal colon cancer.
2, change lifestyle habits
1 and exercise, especially abdominal type, are independent risk factors for colorectal cancer. Too little physical activity is a risk factor for colorectal cancer. Physical activity can affect the colonic peristalsis and facilitate the discharge of feces, thus achieving the prevention of colorectal cancer.
2 The relationship between smoking and colorectal cancer is not very positive, but smoking is a risk factor for colorectal adenoma. The current study believes that smoking is a stimulating factor for colorectal cancer gene production, but it takes about 40 years to occur. effect.
3 alcohol intake is related to colorectal cancer, alcohol is also a risk factor for colorectal adenoma, but the specific reasons are not clear. Reducing alcohol intake is good for preventing colorectal cancer.
4 Reproductive factors Hormone and reproductive factors may affect the occurrence of colorectal cancer. American studies have shown that the incidence of colorectal cancer in single women is higher than that of married women. Some people think that this is related to hormones affecting bile acid metabolism.
Complication
Colorectal carcinoma complications Complications colon polyps
The main complication is cancer metastasis, which can be life-threatening if not treated in time.
Symptom
Colorectal cancer symptoms Common symptoms Diarrhea and constipation alternate blood in the stool and blood and feces mixed abdominal discomfort Defecation frequency abnormal
Iris carcinoid
Preoperative diagnosis of appendix carcinoid is difficult. Most patients are occasionally confirmed during appendicitis surgery, but there are also very few carcinoids in the appendix root infiltration and cecal mucosa. Colonoscopy can see changes around the appendix opening or a single small uplift. Sexual changes, deep biopsy tissue can be diagnosed.
2. Rectal carcinoid
Anal finger examination can be used to treat sputum and submucosal masses. The quality is hard and the edges are clear and smooth. Colonoscopy can see the wide base bulging mass in the rectum. It is hard and smooth, similar to hyperplastic polyps. The diagnosis depends on histopathological examination. Therefore, the diagnostic rate is directly related to the biopsy technique. For smaller tumors, the tumor should be taken as far as possible, and if necessary, electrocoagulation should be removed for whole tumor biopsy.
3. Colon carcinoid
Endoscopically, the carcinoid is yellowish or grayish white, with a hemispherical bulge and no polypoid. The surface is smooth, and the central part often shows a deformed depression. If the carcinoid surface may have ulceration, it is not easy to distinguish from colon cancer.
Examine
Colorectal cancer examination
1. Biopsy tissue can be confirmed by pathology.
2. Colonoscopy can be seen in the rectum to see a broad-based bulging mass, hard, smooth, similar to hyperplastic polyps.
Diagnosis
Diagnosis and diagnosis of colorectal carcinoid
The diagnosis of carcinoid depends on the correct material and pathological biopsy of the tumor. There are characteristic morphological changes in histology: the tumor cells are small, the shape is uniform, the shape is round, the nucleus is small and regular, and the tumor cells form nested or fake chrysanthemum. The shape of the structure, it is worth noting that carcinoids often have other tumors at the same time or in succession, so endoscopy should not be satisfied with the discovery of one or a tumor, but should be carefully examined before surgery, during surgery, and after surgery. Follow-up during the review period for timely diagnosis and treatment.
If colonic carcinoids have large surface ulcers, they are not easily distinguished from colon cancer at this time.
Patients with colon cancer may have no symptoms at an early stage, or have intermittent pain and discomfort in the abdomen. They are often not noticed, and there is no change in bowel habits. Sometimes there may be mild diarrhea or diarrhea, and constipation alternates. As the disease progresses, The patient's abdomen is full of discomfort, and there may be persistent dull pain, obvious changes in bowel habits, increased frequency, loose stools or thick blood and bloody stools. Patients with advanced stage often show anemia, weight loss, persistent dull abdominal pain, or paroxysmal aggravation. The stool is mostly mucus bloody stool or bloody stool. When there is intestinal obstruction, it can be manifested as high abdominal distension, abdominal cramps, accompanied by nausea and vomiting.
