| Objective:Summary of 50 cases of neuroendocrine tumor of the clinical characteristics of digestive system, analysis of the factors associated with prognosis.Methods:Collected from January 2012 to October 2012, the first affiliated hospital of guangxi medical university information complete digestive system neuroendocrine tumours, a total of 50 cases, the 2010 WHO classification of diseases were retrospectively summarized and analyzed the clinical pathological characteristics and prognosis.Results:1. In the study of the digestive system neuroendocrine tumor Patients,19 cases (31 male and female, male:female ratio is 1.63:1, the average age of 51.5 years. Colorectal accounted for 46%(23/50), stomach accounted for 24% (12/50), pancreas (14%) (7/50).2. The atypical clinical symptoms, more is given priority to with abdominal discomfort, mostly belonging to non-functional tumors.3. The detection rate of all kinds of inspection means of endoscopic ultrasonography respectively 100%(10/10), the common endoscopic 97.2% (35/36), magnetic resonance imaging (MRI) 91.6%(11/12), CT88%(38/43), Ultrasonography 74% (20/27).4. The report, a total of 46 cases of tumor size, the largest 19 cm, minimum 0.2 cm,2 cm or less, a total of 28 cases (60.8%), there were 18 cases (39.2%)> 2 cm. Described according to pathology report infiltration depth, a total of 49 cases of T1 phase, a total of 23 cases (47%, the mucosa and submucosa tumor invasion and 1 cm or less), T2 stage, a total of 8 cases (16%, muscular tumor invasion or serous, lower or> 1 cm), T3, a total of 8 cases (16%, serous tumor invasion), T4, a total of 10 cases (20%, tumor distant metastasis).5. According to the new disease diagnosis standard, neuroendocrine tumor (31/48),64.5% of G1 for 21 cases (41.7%), G2 for 10 cases (20.8%). Neuroendocrine carcinoma,35.5%(17/48). Syn were 90%(45/50), CgA were 66%(33/50). In patients with different pathological G grading of tumor diameter (P= 0.002), T stage (P=0.000), lymph node metastasis (P=0.000), and distant metastases(P=0.002).6. In treatment, radical surgery, a total of 39 patients lost to follow-up (1 cases), including endoscopic radical excision of 13 examples (ESD11, EMR2),8 cases of anal excision,18 cases of laparoscopic radical operation and laparotomy. Palliative resection in 5 cases (2 cases were lost to follow-up, no surgical treatment of 6 cases (1 case lost to follow-up).7.Follow-up of 46 cases,4 cases were lost to follow-up, follow-up rate was 92%, 32 people were alive, the late 14 people, overall survival rate was 69.6%. After the application of SPSS for patients survival analysis it is concluded that the following factors:the tumor location (χ2= 19.05, P=19.05), T stage (χ2= 38.864, P=38.864) and grade of G (χ2= 34.362, P=0.000), with and without lymph node metastasis (χ2= 30.921, P=30.921), presence of distant metastasis (χ2=12.702, P=0.000), treatment (χ2=4.484, P=4.484), the operation way (χ2=5.063, P=5.063).ConclusionsNeuroendocrine tumors in digestive system belongs to the rare disease, atypical clinical symptoms, endoscopy and imaging examination are the main diagnostic methods, the definitive diagnosis depends on pathological, endoscopic resection or surgery is effective treatment method. Syn and CgA are commonly used in the diagnosis of the disease index, Syn sensitivity is higher than CgA. Tumor size, T stage, lymph node metastasis, and distant metastasis were all affected by the G classification of the tumor. High grade tumor, lymph node metastasis and distant metastasis were all affected the prognosis of the disease. The different location of tumor and treatment choice also affected the prognosis of the disease. |
PDF Full Text Request