Clinical Features And Prognosis Analysis Of Hepatic Neuroendocrine Tumors

Objective:In this study,through the separate statistic analysis of the clinical data of 15 cases of primary hepatic neuroendocrine tumors(PHNET)and 50 cases of metastatic hepatic neuroendocrine tumors(MHNET)that are diagnosed in our hospital,and do the follow-up prognosis.To discuss the clinicopathological features,diagnostic treatment methods and the affecting the prognosis factors of PHNET and MHNET,so that can provide help for better to diagnose and treat this kind of disease.Methods:The clinical data of 65 patients who diagnosed with hepatic neuroendocrine tumors(HNET)in our hospital from November 2010 to November 2017 were collected: 1.General information: age,gender,clinical manifestations,previous medical history,and auxiliary examination,pathological grading and immunohistochemistry;2.Tumor-related information: the location,size,number and lymph node metastasis of liver tumors as well as the primary organ of MHNET;3.Treatment status: whether do the treatment and specific treatment methods;4.Follow-up patients prognosis.The clinical data were statistically analyzed to summarize the primary,clinicopathological features of patients who with transferred hepatic neuroendocrine tumors,diagnostic treatment methods and factors of affecting the prognosis.Results:1.There is no significant difference in the incidence rate of male and female in the PHNET patient group,but in the MHNET group,male patients are more than female.It is more common to be seen that the age of onset in both groups is between 50 and 69 years old.The primary site of MHNET is mostly from the pancreas(42%);2.There are no specificity in both the clinical manifestations and early stage of auxiliary examinations whether for PHNET or MHNET.Histopathology and immunohistochemistry are the golden standard for diagnosis,of which the Synaptophysin(Syn)is more sensitive than Chromogranins A(CgA).In addition,PHNET also needs to exclude primary lesions outside the liver simultaneously;3.The cumulative overall survival rates of PHNET patients at 1 year,2 years and 3years are 80.00%,46.67% and 33.33% respectively,and the cumulative relapse-free survival rates at 1 year,2 years and 3 years are 80.00% and 33.33% and 20.00%respectively.Its prognosis is related to whether do the surgery(P=0.016),pathological grading(P=0.009)and the lymph node metastasis status(P=0.014),but only pathological grading and whether do the surgical treatment can be regarded as the independent risk factor that affecting its prognosis.Gender(P=0.096),age(P=0.200),tumor number(P=0.096),size(P=0.228)and various laboratory testing data,all of them have no significant effect on prognosis.Among the relevant clinical indicators,only the albumin level(P=0.039)and the lymphatic node metastasis status(P=0.025)and pathological grading are correlated with pathological grade obviously;4.In the MHNET group,the cumulative overall survival rates of patients at 1 year,2years,and 3 years are 68.00%,30.00%,and 10.00% respectively.The prognosis is related to the pathological grading(P<0.0001)and the lymph node metastasis status(P=0.004),but whether do surgical treatment(P=0.219),age(P=0.062),gender(P=0.066)have no significant influence for the patients’ prognosis.Conclusion:1.Both PHNET and MHNET occur in the 50-69 years old.The primary lesion of MHNET is mainly located in the pancreas.The patient lacks specific clinical manifestations in the early stage,so the diagnosis depends on histopathology and immunohistochemistry,meanwhile,it needs to confirm that whether has the primary lesions outside liver.2.Surgical resection is the most effective treatment method,of which the effect of simple surgical resection and surgery combined with other treatments on PHNET prognosis is not significantly different;3.For patients with PHNET,only the albumin level and the lymphatic node metastasis status have a significant correlation with pathological grading.Whether do surgical treatment,pathological grading,and the lymph node metastasis status have statistically significant effects on the prognosis of patients.Among them,only pathological grading and surgical treatment are independent risk factors that affect the prognosis of patients;4.For patients with MHNET,only pathological grading and lymph node metastasis can significantly affect the prognosis of patients,but gender,age,and whether do surgical treatment has little influence on the prognosis of patients.