作者：陈亚男，刘静

单位：武汉大学中南医院 消化内科/湖北省肠病医学临床研究中心/肠病湖北省重点实验室，湖北 武汉 430071

Authors: Chen Yanan，Liu Jing

Unit: Department of Gastroenterology，Zhongnan Hospital of Wuhan University，Wuhan 430071，Wuhan，China

摘要：

同时性多原发结直肠癌（SCRC）被定义为初始诊断时在患者结直肠中发现一种以上的原发性恶性病变，与单发性结直肠癌相比，是一种比较罕见的结直肠癌类型，以印戒细胞癌为病理表现的同时性多原发结直肠癌更为罕见，因此早期识别极为重要。本文报道1例在回盲部和乙状结肠发生的同时性原发印戒细胞癌的病例，患者为67岁女性，因间断轻度腹痛、腹胀半年入日间病房（24 h出入院），患者仅为行胃息肉切除，考虑患者有腹痛症状，我们建议行腹部计算机断层扫描检查，结果提示回盲部肠壁可疑增厚伴异常强化，进一步完善肠镜、病理确诊为同时性多原发结直肠印戒细胞癌。同时性多原发结直肠印戒细胞癌病理类型差，缺乏典型临床表现，一经发现通常处于晚期，早发现、早诊断对于治疗、预后极为重要。

关键词：印戒细胞癌； 同时性多原发结直肠癌； 病例报道

Abstract：

Synchronous multiple primary colorectal cancer is defined as the discovery of more than one primary malignant lesion in the patient's colorectum at the time of initial diagnosis and is a relatively rare type of colorectal cancer compared to single colorectal cancer. Simultaneous multiple primary colorectal cancer with signet ring cell carcinoma as the pathological manifestation is more rare ，so early identification is extremely important. We reported a case of synchronous primary signet ring cell carcinoma in the ileocecal region and sigmoid colon. The patient was a 67-year-old woman who was admitted to the day ward (24-hour admission and discharge). She was admitted to the hospital for gastric polypectomy. Considering that the patient had abdominal pain symptoms，we recommended abdominal CT examination. The results indicated suspicious thickening of the ileocecal bowel wall with abnormal enhancement. We further performed colonoscopy and histopathologically confirmed the diagnosis of synchronous multiple primary colorectal signet ring cell carcinoma. Synchronous multiple primary colorectal signet ring cell carcinoma has a poor pathological type and lacks typical clinical manifestations. Once found，it is usually at an advanced stage. Early detection and early diagnosis are extremely important for treatment and prognosis.

Key Words:  Joint empowerment; Early gastric cancer; Endoscopic submucosal dissection; Helicobacter pylori; Eradication