Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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The Clinicopathologic Characteristics of Patients with Gastric Carcinoid Tumor

위 유암종의 임상병리학적 특징에 대한 후향적 연구

  • Jang, Jeong-Moon (Department of Surgery, Seoul National University College of Medicine) ;
  • Kong, Seong-Ho (Department of Surgery, Seoul National University College of Medicine) ;
  • Yoon, Hong-Man (Department of Surgery, Seoul National University College of Medicine) ;
  • Ahn, Hye-Seong (Department of Surgery, Seoul National University College of Medicine) ;
  • Lee, Hyuk-Joon (Department of Surgery, Seoul National University College of Medicine) ;
  • Yoon, Won-Jae (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Kim, Sang-Kyoon (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Yang, Han-Kwang (Department of Surgery, Seoul National University College of Medicine) ;
  • Lee, Kuhn-Uk (Department of Surgery, Seoul National University College of Medicine)
  • 장정문 (서울대학교 의과대학 외과학교실) ;
  • 공성호 (서울대학교 의과대학 외과학교실) ;
  • 윤홍만 (서울대학교 의과대학 외과학교실) ;
  • 안혜성 (서울대학교 의과대학 외과학교실) ;
  • 이혁준 (서울대학교 의과대학 외과학교실) ;
  • 윤원재 (서울대학교 의과대학 내과학교실) ;
  • 김상균 (서울대학교 의과대학 내과학교실) ;
  • 양한광 (서울대학교 의과대학 외과학교실) ;
  • 이건욱 (서울대학교 의과대학 외과학교실)
  • Received : 2009.07.29
  • Accepted : 2009.10.26
  • Published : 2009.12.30
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Abstract

Purpose: We wanted to analyze the clinicopathologic characteristics of patients with gastric carcinoid tumor, which is a rare gastric tumor (less than 2% of all gastric tumors). Materials and Methods: We reviewed all the carcinoid patients who were treated from 1996 to 2006. The clinicopathologic characteristics, the treatment modalities and the survival rates were retrospectively analysed. Results: There were 8 type I patients and 10 type III patients, but there were no type II patients. The mean age of onset for type I was 47.75 years and that for type III was 57.90 years. More type III patients were female, but the gender ratio of type I patients was equal at a ratio of 1：1. There were 4 cases of solitary tumor, which were all T1 except for one case, and there was neither distant metastasis nor lymph node involvement for the type T1 cases. In the 13 patients who had no metastasis, 5 underwent endoscopic mucosal resection and 8 underwent surgery, and their combined 5 year survival rate was 92.3%. For the 5 cases who had metastastses, their mean survival was 22 months and especially, 3 of them underwent palliative surgery and their median survival were 24 months (95%, ${\pm}6.52$). Conclusion: Higher incidence of type III gastric carcinoid tumor and less multiplicity in type I gastric tumor were identified in our study compared with previous reports. For the type III cases, there were some noteable differences compared with the Western country's survival rate for the patients who underwent palliative surgery, so physicians must pay close attention to the definite clinicopathologic characteristics of gastric carcinoid patients.

목적: 위 유암종의 임상병리학적 특성과 치료방법 및 예후 등을 분석하였다. 대상 및 방법: 1996년부터 2006년까지 본원에서 치료받았던 18명을 대상으로, 의무기록을 이용한 후향적 연구를 통해 Rindi 분류에 의해 구분하여, 기존의 보고와 임상병리학적 특성 및 치료, 생존율을 비교 분석하였다. 결과: Type I은 8명, type III가 10명이었으며 type II는 없었다. 평균발생 연령은 type I이 47.75세, type III는 57.90세였고, type I은 남자 4명, 여자 4명으로 성비가 1：1이었으나 type III는 남자 7명, 여자 3 명으로 남자에서 많았다. Type I에서도 단발성인 경우가 4예가 있었으며, 1예를 제외하고는 점막 또는 점막하층에 국한되어 있고, 림프절 전이나 원격전이는 없었다. Type III는 병변의 침습성에 관계없이 모두 국소림프절 전이 또는 원격 전이가 있었다. 진단 시 원격전이가 없었던 13명 중 5예에서 내시경적 절제술, 8예에선 수술이 시행되었으며 5년 생존율은 92.3%였다. 원격 전이가 있었던 5예는 평균 생존 기간이 22개월로 이 중 고식적 수술을 시행 받은 3예의 중위 생존 기간은 24개월이었다(95%, ${\pm}6.52$). 결론: 기존의 Rindi 분류법과 비교하여 보았을 때, 본 연구 결과 빈도에 있어서 type III가 type I보다 흔하였다. 또한 type I 유암종에 있어서 평균연령이 낮고, 단발성 종양이 절반 정도를 차지하며, 악성빈혈이 동반되지 않았던 점 등에서 서구와는 다른 특징이 관찰되었다.

Keywords

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