| Objective:Neuroendocrine neoplasms(NENs)are heterogeneous tumors originating from neuroendocrine cells,which can be widespread throughout the body.Among them,colorectal neuroendocrine neoplasms(CRNENs)are relatively common.In this study,the clinicopathological features of patients with CRNENs in the Surveillance,Epidemiology,and End Results(SEER)database and Taizhou People’s Hospital of Jiangsu Province were summarized.The related factors affecting the prognosis of patients were analyzed and a nomogram prediction model was established,which can provide an intuitive reference tool for clinicians to evaluate patient survival.Methods:1.Patients with CENRNs diagnosed from 2010 to 2015 were identified in the SEER database,and 7623 cases with complete clinical,pathological and survival data were screened and designated as SEER group;A total of 114 patients with CRNENs diagnosed by pathological examination from October 2016 to October 2021 in Taizhou People’s Hospital were collected as the hospital group,the clinicopathological data of the patients were gathered and followed up.2.SPSS.26 statistical software was applied to analyze the basic data between the two groups of patients,Kaplan-Meier method was used for survival analysis,and the Log-Rank test was used to compare the overall survival status between the two groups.3.The COX regression model was used to analyze the prognosis of patients in SEER group and screen out the independent factors affecting patient survival.Then a Nomogram model for predicting the 1-,3-,and 5-year survival rates of patients was constructed using R language,and evaluate its accuracy and reliability.Results:1.There were 7737 patients in this study,including 7623 patients in the SEER group and 114 patients in the hospital group.There was a trend of increasing incidence in both groups year by year.50-60 years old was the high incidence age of the disease,with slightly more male patients than female patients.The primary site of the tumor was more common in the rectum,and the pathological type was highly differentiated neuroendocrine tumor.The most common treatment for the disease was in situ tumor resection.2.The SEER group could not obtain information about the clinical manifestations of patients.None of the patients in the hospital group had specific clinical manifestations,most patients found lesions during physical examination,and a few patients had non-specific clinical manifestations,such as abdominal discomfort,stool shape and defecation habits.3.Colonoscopy data was not available in the SEER group.All patients in the hospital group underwent colonoscopy.Most of the tumours appeared yellowish under the microscope,and the most common was flat uplift,accounting for 47.37%(54/114).108 patients(94.74%)underwent ultrasound endoscopy,with a diagnostic accuracy rate of 90.74%(98/108).4.The pathological results of the SEER group showed that there were 6022 cases of neuroendocrine tumors,1544 cases of neuroendocrine carcinomas and 57 cases of mixed glandular neuroendocrine carcinomas,and no patient immunohistochemical information was given.There were 111 cases of neuroendocrine tumors,3 cases of neuroendocrine carcinomas and no mixed adenoneuroendocrine carcinoma in the hospital group.Immunohistochemical results showed that the positive rate of synaptophysin was 98.25 %(112/114),the positive rate of nerve cell adhesion molecule56 was 84.21 %(96/114),and the positive rate of chromogranin A was 61.40 %(70/114).The sensitivity of synaptophysin was significantly higher than that of chromogranin A.5.The mortality rate of patients in the SEER group was 10.39%(792/7623),and the 1-year,3-year and 5-year survival rates were 93.86%,88.98% and 85.11%,respectively;the case fatality rate of patients in the hospital group was 2.63%(3/114),and the 1-year,3-year and 5-year survival rates were 98.25%,97.30% and 97.17%,respectively.6.The survival analysis of the SEER group showed that age,pathological type,location,degree of tumor differentiation,tumor diameter,T stage,N stage,M stage and surgical information were independent factors affecting the prognosis of patients.7.The Nomogram model for predicting the 1-year,3-year and 5-year survival rates of CRNENs patients was constructed,and its area under the receiver operating characteristic curve for predicting the 1-year,3-year and 5-year survival rates of patients was 0.900,0.932 and 0.924,respectively.The model consistency index obtained from the internal and external datasets was 0.923 and 0.998,respectively.The predictive ability of the model was tested by the Bootstrap method,and the results showed that there was a high consistency between the predicted survival rate of the model and the actual survival rate of the patient.Conclusion:1.The incidence of colorectal neuroendocrine tumors is increasing every year,most of which occured in 50-60 years old male.Most of the tumors are primary in rectum,and highly differentiated neuroendocrine tumors are the most common.2.Patients with colorectal neuroendocrine tumors were lack of specific clinical manifestations,and their diagnosis is dependent on pathological examination and immunohistochemical examination.3.Age,pathological type,location,degree of tumor differentiation,tumor size,T stage,N stage,M stage and surgical information are independent factors affecting the prognosis of patients with colorectal neuroendocrine tumors.4.The Nomogram predictive model constructed in this study to predict the survival of patients with colorectal neuroendocrine tumors has a superior predictive ability. |
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