The Clinical Analysis Of Gastrointestinal Neuroendocrine Neoplasm In 265 Cases

BackgroudNeuroendocrine neoplasms (NEN) is a group of heterogeneity tumor originating from neuroendocrine cells.It can occur in any part of our body,including the digestive tract, respiratory tract, mediastinum, liver, kidney, endocrine glands, as well as the pancreas, etc. The incidence of gastroenteropancreatic neuroendocrine neoplasm (GEP-NENs),which is the most common of NENs,accout to 55-70%. GEP-NEN was thought of a rare disease for a long time, but recent studies have showed that its incidence is obviously rising.Yao,etc.[1] retrospectively analyzed the incidence of GEP-NEN from 1973 to 2004 in the United States and found that the incidence of neuroendocrine tumor rised from 1.09/100000 to 5.25/100000, a increasing of 380%. Inadequacy understanding of GEP-NEN and lack of typical clinical manifestations,diagnosis is relatively difficult.This article is written about 265 cases of GEP-NEN from Shandong provincial hospital in 2011-2015,265 in order to having a better understanding of GEP-NEN,improving the level of diagnosis and prognosis.Method265 patients were confirmed by pathological diagnosis with GEP-NENs in Shandong Provincial Hospital from July 2010 to December 2015. By the method of retrospective analysis, collect the clinical data including gender, age, primary site, clinical symptoms,pathological results,t and postoperative survival situation,then based on the statistical analysis the conclusions are obtained.Results1、In all the 265cases,the onset age is 14-82,the mean age is 55.4, the median age is 56.30.2、There are 265 cases and the number of male and female are 181 and 84。 The rate is 2.15:3、f all the 265 cases, stomach 75(28.30%), pancreas 44 (16.60%), rectum (42 cases,15.85%), esophagus (38 cases,14.34%),cardiac (28 cases,10.57%), colon (11 cases,4.15%), liver (7 cases,2.64%), duodenal (7 cases,2.64%), small intestine (2 cases,0.75%).4、There are 255 functional GEP-NENs and 9 non-functional GEP-NENs.Haven’t typical clinical manifestations and different type of NEN have different clinical manifestations which are closely related to their primary site.The most common is abdominal discomfort and abdominal pain, Others include astrointestinal bleeding, nausea and vomiting, etc.5、Of all the patients,NET 104 cases (39.25%), NEC 134(50.57%), MANEC 22 cases (8.30%).Gl phase 86 cases (32.45%),18 cases (6.79%) of the G2, G3 phase 156 cases (58.87%), Syn(positive) 248 cases(96.80%), CgA(positive) 192 cases,(75.0%)6、Endoscopic excision 34 cases (12.83%), surgery 183 cases (69.06%),48 cases (18.11%) without surgical treatment. Surgery is the mainly treatment of GEP-NEN.7、For G1 phase patients, surgery and endoscopic resection have no differences in treatment by Kaplan and Meier statistical analysis. They have similar overall suviral time.8、Overall surviral time of G1 and G2 are about 59.86 month while G3 are about 32.70 month. There are obvious differences between them.9、We followed up 214 cases, the follow-up rate was 81%, the follow-up time is 1-63 months, average follow-up time for 39.7 monthsAccording to the results of survival analysis, location, pathological grading, T stage, lymph node metastasis, distant metastasis affect the prognosis of patients.Conclusions1、Cases of GEP-NENs are increasing year by year, of which men has a higher morbidity than women. People may get the disease at any ages.2、GEP-NENs occur most in stomach, followed by pancreas, rectum, esophagus,cardiac, colon, liver, duodenal and small intestine.3、Haven’t typical clinical manifestations and different type of NEN have different clinical manifestations which are closely related to their primary site.4、NEC is the most common type followed by NET,MANEC.The Syn and CgA is the most commonly immunohistochemical index and Syn has a higher positive rate.5、Surgery is the mainly treatment of GEP-NEN.6、For G1 phase patients, surgery and endoscopic resection have no differences in treatment.7、G1/G2 have a longer overall surviral time than G3.8、location, pathological grading, T stage, lymph node metastasis, distant metastasis affect the prognosis of patients.