대장 인환세포암의 임상적 특징
Primary Signet Ring Cell Carcinoma of the Colon and Rectum
대한암학회지 1998년 30권 3호 p.521 ~ 526
소속 상세정보
김희철/Hee Cheol Kim
김창남/정춘식/유창식/김병식/이헌경/김진천/Chang Nam Kim/Choon Sik Jeong/Chang Sik Yu/Byung Sik Kim/Hun Kyung Lee/Jin Cheon Kim
KMID : 0360319980300030521
Abstract
서론
인환세포암은 세포질내 점액으로 인하여, 핵이 편향되어 형성되는 특징적인 인환세포로
이루어지는 선암의 조직학적 형태이다. 이는 주로 위에서 호발하며, 이외 췌장, 유방, 담낭
등에서 나타날 수 있는데, 대장에서는 매우 드물게 발생한다. Laufman과 Saphir가 3예의 대
장 인환세포암을 보고한 이후, 영문논문에서 1996년까지 약 270예 이상이 보고되고 있지만,
임상적, 병리적 특징은 각 보고마다 다양하게 나타나고 있다.
본 연구는 13예의 원발성 대장 인환세포암의 임상 및 생물학적 특징을 분석하고 적절한
치료 방법을 모색하고자 했다.
Purpose : Signet ring cell carcinoma is a rare type of adenocarcinoma in the colon
and rectum. We evaluated the differences of clinical features between colorectal signet
ring cell carcinoma and ordinary adenocarcinoma.
Materials and Methods : The clincopathologic data of 13 cases with primary colorectal
signet ring cell carcinoma were reviewed. The primary colorectal signet ring cell
carcinoma was diagnosed when following criteria were met: 1) the tumor was primary;
2) histologic material was adequate; 3) signet ring cells represented more than 50% of
the cancer.
Results : Patients ranged in age from 20 to 68 (median, 45) years; 7 were male, and 6
were female. Three tumors were located in the proximal colon, 3 in the distal colon, and
7 in the rectum. There was no case that had family history. Most cases (77%) were
stage Ⅲ, one was stage Ⅱ, and two were stage Ⅳ with peritoneal seeding. There were
9 cases that showed local recurrence or distant metastases during follow-up periods 6
cases with peritoneal seeding, 3 with bone metastases, 2 with brain metastases and 1
with pelvic recurrence (two cases had either bone and brain metastasis, and one case
had bone and peritoneal seeding). Prognosis was extremely poor, and overall two years
survival rate was 25%.
Conclusion : Early onset, mode of metastasis and poor prognosis may imply the
different biologic behavior of signet ring cell carcinoma, compared with ordinary
adenocarcinoma. To improve outcome, early diagnosis and radical operation should be
stressed.
키워드
Signet ring cell carcinoma; Colon and rectum; Poor prognosis;
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