Diagnosis And Treatment Of Gastric Neuroendocrine Tumors (Report Of9Cases) And Review Of The Literature

Objective: To discuss the clinical features, diagnosis, treatment andprognoses of gastric neuroendocrine tumor.Methods:9patients with gastric neuroendocrine tumor that underwentsurgery between January2005and April2011at First Affiliated Hospital ofGuangxi Medical University were retrospectively evaluated.Results:9patients were all confirmed by pathology. There were6malepatients,3female patients in this group. The age ranged from31to64years oldand the average was44.7years old. Clinical symptoms are mainly abdominalpain (7cases), moreover,1case were anemia,2cases were vomiting,1casehad melena and5cases had chronic gastritis history more than five years. Themain body signs is abdominal tenderness,7cases, the other is abdominal mass,1cases. Auxiliary examination：The9cases in this group were performed CTexamination,2cases found stomach lesions,3cases found stomach lesions andabdominal metastatic lesions. The9cases were performed gastroscope inspection, lesions located in stomach body2cases; Gastric antrum4cases;Gastric body+gastric antrum3cases. Lesions characteri: stomach neoplasmcombined with chronic gastritis in5cases, of which four cases of a single, and1case of multiple, the neoplasm size were0.3~1.6cm; multy mass combinedulcer in3cases, ulcer4.0cm in diameter biggest, the mass, diameter0.3~0.8cm; A single neoplasm combined ulcer in3cases, ulcer were2~7cm indiameter, the neoplasm size were0.5~3.5cm. Gastroscope pathology in2cases were misdiagnosed as low differentiated adenocarcinoma,2casesdiagnosed as possible carcinoma,5cases diagnosed gastric neuroendocrinetumor. Three cases were performed ultrasound gastroscope inspection whichindicating that the tumor invasion levels and postoperative pathologic were thesame.Treatment:the9cases in this group were all performed surgery.3caseswere performed laparoscopic surgery (1case receiving radical distalgastrectomy，1case receiving gastric body tumor resection,1case receivingradical total gastrectomy),6cases were performed open surgery(2casesreceiving radical proximal gastrectomy,3cases receiving radical distalgastrectomy,1case receiving radical total gastrectomy). There were4cases inthis group performing routine adjuvant chemotherapy and two cases performingSomatostatinoma after surgery. pathology result:all the9cases hadPostoperative pathologic. Among these gastric neuroendocrine tumor,3caseshad infiltrated to whole thickness of the stomach and had lymph nodemetastasis,1case had infiltrate to muscular layers,2cases had infiltrate tomucous layers,3cases had infiltrate to submucosal layers.Followed up: all the9cases in this group were followed up,1case were death after18months, fourcases survive more than24months and the longest one was54months.Conclusions: Gastric neuroendocrine tumor has no specific clinical symptoms and signs. Diagnosis of gastric neuroendocrine tumor mainly relis ongastroscope, pathologic biopsy and immunohistochemistry and they areimportant basis and main ways for the preoperative diagnosis. CT，gastroscopeand ultrasonic gastroscope can find lesions and metastases which is importantfor the diagnosis of tumors and staging. Lesions often located in the gastricbody, gastric antrum and the morphology mainly are polyps. Operation is thefirst choice for gastric neuroendocrine tumor but the specific operation methodremains controversial. We need further research and long-term follow-up so thatwe can draw a clear conclusion.