Analysis Of Diagnosis And Treatment Of Neuroendocrine Neoplasms (Report Of42Cases)

Objective It is confused to diagnose the Neuroendocrine neoplasms early as these symptoms are always atypical in the patients. The patients appear to worse survival after irrational diagnosis and therapy when neoplasms progress or exhibit symptoms. To discuss primary disease characteristics, testing items, current treatment options and survival prognosis of neuroendocrine neoplasms based on the material from the first Hospital of Lanzhou University.Methods We have collected clinical materials of42patients, including pathologic and laboratory examination, imaging information and treatments. The patients were admitted to the first Hospital of Lanzhou University from January2011to the end of June2013. Total patients were diagnosed with neuroendocrine neoplasms. We analyzed the median survival time and2-year survival rate in different groups in which patients had various clinical features. We sum up the experience of clinical diagnosis and treatment and study on related factors affecting the prognosis of the disease.Results Among forty-two cases of neuroendocrine neoplasms, thirty-two cases were males, ten cases were females, aged from17to79years. The median age was59.20cases were from gastrointestinal and pancreatic neuroendocrine neoplasms,11cases were from bronchopulmonary tumors. The11cases were from other location. Metastasis occurred when diagnosis for22cases. Immunohistochemical detection of tumor markers was tested including synaptophysin, chromogranin A and epithelial membrane antigen. The Nonparametric test of comparison of three kinds of indicators, p<0.05, the results have statistically significant difference; the positive rate of EMA was lower than the other two groups. Following time is0-34months ending up to January2014, the median time was13.5months although12cases were lost. The patients were classified with stage II, III and IV,2-year survival rates were68.6%,56.3%and26.3%respectively. The patients were classified by Ki-67proliferation index test and labeled with no-reported, G1-2, G3,2-year survival rates were41.5%,100%and35.5%. There were no statistically significant differences among different TNM stages and pathological grades on the2-year survival rate (Log-Rank tests P>0.05). The median survival time was19months in all cases. The2-year survival rate in transfer groups of22cases and no-transfers groups of20cases were28.5%,68.8%respectively, the median survival times in transfer groups was15months. Surgical groups and no-operative groups were26and16cases respectively,2-year survival rates were71.2%and0, the median survival time in no-operative groups was12months; The median survival time of gastrointestinal of20cases was19months and that of bronchopulmonary of11cases was16months, the other11cases was no drawing median survival time,2-year survival rate were44.2%,0,88.9%respectively. Single-variable analysis showed that surgery,different organs and transfer were related to survival time, survival ratio had statistical difference (Log-Rank tests P<0.05). Cox proportional-hazard regression model showed that surgery was independent factor influencing overall survival.Conclusion1.Surgery could improve the patients survival time obviously;2.There were significant statistically differences among patients with different sites of neuroendocrine neoplasms. The lifetime is shorter in the patients with tumors of transfer groups.