| Objectives:The clinical pathological data of colorectal neuroendocrine neoplasms were analyzed,and found out the relationship between clinical characteristics and the survival of colorectal neuroendocrine neoplasms.aimed at providing some help for the clinic diagnosis and treatment of colorectal neuroendocrine neoplasms.Method:Totally 116 patients of colorectal neuroendocrine neoplasms in the Fourth Hospital of Hebei Medical University from January 2005 to December2016 were analyzed retrospectively.We analyzed the relationship between the clinical characteristics and survival of colorectal neuroendocrine neoplasms.Results:Among the 116 patients of colorectal neuroendocrine neoplasms,84 cases were men and 32 cases were women.Male-to-female ratio was 2.63:1.The onset age was 22-77 years.The median age was 57±11.5 years.Peak age was 50-70 years.73 cases were in rectum,43 cases were in colon.Among them,14 cases(13.9%)in the cecum,10 cases(7.9%)in the ascending colon,5 cases(3.96%)in transverse colon,6 cases(5.94%)in the descending colon and 8 cases(6.9%)in the sigmoid colon.The average diameter of tumor was9.96±11.09 mm(2 mm-80 mm).The diameter of tumors:98 cases(84.5%)were less than l0mm;10 cases(8.6%)were 10-20mm;8 cases(6.9%)were more than 20mm;Among them,6 cases were 21-50 mm,6 cases were51-80 mm.74 cases were NET G1,32 cases were NET G2,7 cases were NEC,3 cases were MANEC.A total of 116 cases had described the infiltration layer,102 cases(87.93%)were T1,2 cases(1.72%)were T2,5 cases(4.31%)were T3,7 cases(6.03%)were T4.Immunohistochemistry staining determined a80% positive rate of Syn,45.1% positive rate of CgA and 60.2% positive rate of NSE.No lymph nodes metastasis.The positive rate of colon and rectal NENs Syn was 78.05% and 69.57% respectively;The positive rate of colon and rectal NENs CgA was 43.90% and 45.83% respectively;The positive rate of colon and rectal NENs NSE was 64.29% and 58.18% respectively.Among the 116 patients of colorectal neuroendocrine neoplasms,13 patients with lymph node metastases,lymph node metastasis were not found in 103 cases.The liver was major organs for distant metastases.Among them 1 case was found when there had been the liver,lungs,bones and the multiple lymph node metastasis,1 case was found when there had been the liver,lungs and abdominal lymph node metastasis,2 cases were found when there had been the liver,abdominal cavity and retroperitoneal lymph node metastasis.Among the 116 patients of colorectal neuroendocrine neoplasms,101 patients were given endoscopic treatment.EMRC:56 cases EMR:31 cases,ESD:14 cases.Of these 101 patients,2 cases(1.98%)developed delayed bleeding and recovered after endoscopic hemostasis and conservative treatment.13 patients underwent the surgery with curative surgery(11 cases)and palliative surgery(2 cases).2 cases were treated conservative treatment because of distant metastasis.Of the 116 patients,101 patients with endoscopic treatment were given review regularly,no special treatment;Another 15 patients,9 patients were given chemotherapy,1case was found with the liver,lungs,bone metastasis,then leave hospital;5 patients discharged from hospital after the surgery,no postoperative chemotherapy.8patients lost to follow-up.93 out of 116 patients received long-term follow up.99 cases with stable disease,7 cases progressive disease,2 cases of death,Among them,the longest follow-up time was 118 months,the shortest time follow-up was 2 months;The median follow-up time was 33.76 ± 26.43 months.Two patients died,all because of tumor progression,recurrence and metastasis.Overall survival rate was 98.28%.Of the 108 patients,colorectal NET G1 : 66 cases,the average survival time was 33.47±27.87 months,All patients with colorectal NENs G1 stage were given endoscopic treatment,all survived,1 year,3 years,5 years survival rate were 100%.Colorectal NET G2,32 cases,the average survival time was 30.12± 22.35 months,27 cases of endoscopic treatment were all survived,1 year survival rate was 100%,3 year survival rate was 95%,5 year survival rate was 83%.Colorectal NEC,7 cases,the average survival time was 19.56± 17.24 months,1 year survival rate was85.7%,3 year survival rate was 42.9%,5 year survival rate was 14.4%.MANEC,3 cases,the average survival time was 16.7± 7.74 months,1 year survival rate was 66.7%,3 year survival rate was 33.3%,5 year survival rate was 0%.Tumor size(P=0.028),G stage(P=0.011),tumor infiltration depth(T staging)(P=0.001),lymph node metastasis(P=0.035),Ki-67 index(P=0.001)and distant metastasis were independent factors of prognosis.Conclusions:The incidence of colorectal NENs rose year by year,Male has a higher morbidity than female.The incidence of rectum is higher than colon.There are more cases from 50 to 70 years old.Carcinoid syndrome is rare in colorectal neuroendocrine neoplasms.The size,grading,stage of tumor are closely related with the prognosis of colorectal NENs.Tumor size(P=0.028),G stage(P=0.011),tumor infiltration depth(T staging)(P=0.001),lymph node metastasis(P=0.035),Ki-67 index(P=0.001)and distant metastasis had obvious difference with prognosis of patients.Tumor diameter ≤ 10 mm,pathologic stage for G1 stage,tumor stage T1,endoscopic treatment,prognosis was good.Tumor diameter > 20 mm,Ki-67 index was higher,the tumor T staging and grading G was later,lymph node and distant organ metastasis,Could not be surgery,prognosis was poor. |
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