| Neuroendocrine neoplasm(NEN),which originates from peptidergic neurons and neuroendocrine cells in the body.The neoplasms have obvious heterogenicity and occur in diverse sites throughout the body.In recent years,the incidence of NEN is increasing obviously.The digestive system is the main site of NEN.Gastroenteropancreatic neuroendocrine neoplasm(GEP-NEN)accounts for more than half of all NEN.In recent years,the incidence of gastric NEN has risen substantially.Gastric NEN has obvious heterogeneity,which can be divided into different subtypes according to its etiology,pathogenesis and pathological grade.In our country,gastric NEN is divided into 4 types,that is,well differentiated gastric neuroendocrine tumors are divided into 3 types,poorly differentiated mixed adenoendocrine carcinoma and neuroendocrine carcinoma are divided as type 4.At present,our country still lacks the large sample research data of the gastric NEN.This paper will make a comprehensive retrospective analysis of the data of gastric NEN in our hospital in recent years,to explore the clinicopathological characteristics of gastric NEN and the related risk factors affecting its metastasis and prognosis,and to provide theoretical support for the diagnosis and treatment of gastric NEN.ObjectiveThe incidence of gastric NEN is not uncommon.Through retrospective analysis of the clinicopathological features of gastric NEN,we screened the risk factors that affect the metastasis and prognosis of it,which is contribute to the early discovery,diagnosis and treatment of the disease.Gastric NEN has obvious heterogeneity,which can be divided into 4 subtypes according to its etiology and pathogenesis.In addition,G3 grade gastric NEN was further divided into well-differentiated G3(NET G3)and NEC,we will compare the prognosis of different types of gastric NEN and that of NET G3 and NEC in this study.MethodsFrom January 2011 to November 2018,the clinical data of one hundred eighty three patients diagnosed as gastric NEN were collected by endoscopic biopsy or surgical pathology in the First Affiliated Hospital of Zhengzhou University.Spss23.0 statistical software was used to analyze the collected data.Classified variable data was expressed as percentiles.Multivariate logistic regression analysis was used to predict the risk factors of tumor metastasis.Kaplan-Meier survival analysis was used to evaluate the prognosis of patients.Results1.Among the 183 patients with gastric NEN,the male to female ratio was 2.16.There were 49 cases(26.8%)in type Ⅰ,8 cases(4.4%)in type Ⅱ,29 cases(15.8%)in type Ⅲ,97 cases(53.0%)in type Ⅳ.Type Ⅳ was more common in males(67.2%)and Type Ⅰ was(53.4%)in females.2.Of all the patients,NET(68 cases,37.2%),NEC(82 cases,44.8%),MANEC(15 cases,8.2%).For G grades,115 cases(62.8%)were G3 grade,36 cases(19.7%)were G2 grade,32 cases(17.5%)were G1 grade,the other 18 cases of G3 were classified as NET G3.3.Univariate analysis showed that gender,age,tumor diameter,grade,classify and clinical classification were important factors affecting metastasis.Multivariate logistic regression analysis showed that tumor diameter and pathological grade were important predictors of metastasis.4.Univariate analysis showed that risk factors of affecting prognosis included gender,age,grade,classify,clinical classification and metastasis.The multivariate analysis showed that metastasis was the independent risk factor of the prognosis.The median survival time of all G3 gastric NEN patients was 23.0 months and the median survival of patients with gastric NEC was 21.0 months.The median survival time of G3 gastric NEN was 41.0 months in the non-metastatic group,which was significantly higher than that in the metastatic group(median 21.0 months).The survival rate of NET G3 group(72.2%)was significantly higher than that of NEC group(51.9%).Conclusion1.Gastric NEN has obvious heterogeneity,which can be divided into four different subtypes according to its etiology and pathogenesis.Type patients Ⅰ were more common in females and Type patients Ⅳ were more common in males.2.The diameter and grade of tumors were important predictors of metastasis of gastric NEN.3.Kaplan-Meier survival analysis showed that gender,age,grade,classify,clinical classification and metastasis were the risk factors affecting the prognosis of gastric NEN.Cox regression analysis showed that metastasis was an independent risk factor affecting the prognosis of gastric NEN.The survival time of patients without metastasis is longer than that of patients with metastasis.The median survival time of G3 gastric NEN was 41.0 months in the non-metastatic group,which was significantly higher than that in the metastatic group(median 21.0 months).The survival rate of NET G3(72.2%)was significantly higher than that of NEC(51.9%). |
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