| Objective:To reassess previously diagnosed80cases of digestive tract neuroendocrine tumors based on the last WHO concept,and study the incidence rate, inheritance tendency, clinical characteristics, diagnosis, validity of drugs, prognosis of the digestive tract neuroendocrine tumors, to improve the clinical diagnosis and treatment of these diseases.Material:The clinical data of80cases with gastrointestinal neuroendocrine tumors were collected in the pathology department of Qilu Hospital from July2005to November2012, including61cases of male,19cases of female, the rate was3.21:1. The average age was57years old(ranged from30to80years old),79of whom underwent surgical operation,1did not undergo operation, but were taken biopsy for pathological, Pathologists rereading,immunohistochemical processing,and detection of three indexes of CgA, Syn and Ki67positive index acording to the last WHO concept.Methods:Eighty cases in tissue were studied by immunohistochemistry with panels of Syn,CgA And Ki67positive index,and carried out in the staging and grading.A follow-up study of45cases of the patients was made to analyze the disease. And this study mainly analyzed the clinical features, efficiency of surgical operations, drug efficiency, survival rate and other related information, then drawn some conclusions of these data.Results:1. Of the80patients, the numbers of male and female were61and19, the rate was3.21:1. Male are more likely to suffer from NENs. The age ranged from30to80years old, the average age of57years old, most patients were50to70years old, the disease incidence rate was affected by gender and older age, male and the old were the common patients of the disease.2. Of the80cases,there were20esophageal NENs,34gastric NENs,4duodenal NENs,l small intestinal NENs,2colon colonic NENs,19rectal NENs.The typical characteristics of carcinoid syndrome in GI-NENs were not as common as expected. symptoms and signs were similar in advanced stage malignant tumor, typical carcinoid syndrome appear rate was not high, The cases were sporadic, no obvious family aggregation and genetic predisposition.3.The GI-NENs have a high rate of misdiagnose.Even after the digestive endoscopic examination, without a pathological diagnosis, the rate of an erroneous diagnosis was still very high (above90%). The typical carcinoid syndrome or other specific symptoms can greatly reduce the misdiagnosis rate.4.The pathological diagnosis, immunohistochemistry was an important means of pathological diagnosis. Syn and CgA were the most common substance to indicate the NENs, and the sensitivity of Syn is higher than CgA.5.45cases were followed up, the prognosis related to tissuetype, the prognosis of NET was better than NEC. Clinical stage and Ki67positive index was used as an independent prognostic factor, the favorable prognostic factors include women, young, with hormone syndrome years hormone syndrome early clinical stage, tumor grade, tumor metastasis free of small, low, application of drugs.Conclusions:1.The neuroendocrine neoplasm was a clinically rare,slow growth,low-grade malignant tumor, however the incidence was increased in recent years.2. Many factors influence the incidence rate of GEP-NENs, male have a higher chance to get the disease. People among all ages can get the disease, but the most common age was between50and70.3. GI-NENs varied clinical characteristics, The carcinoid syndrome is not as common as expected. The clinical misdiagnosis rate was high, the pathological diagnosis was the main diagnostic method.4. Surgical operation was the most effective way to treat the disease. Many drugs can be used as the secondary treatments,such as targeted therapy, chemotherapy and hormone drugs.5. The prognosis of this disease is affected by many factors, such as histological type, sex, gender,tumor size, invasion, growth location, metastasis, drugs, et al.Clinical stage and the Ki67index can be used as independent prognostic factors. |
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