| Objective:Through retrospective analysis of clinical data of gastrointestinal neuroendocrine tumors(GI-NETs),the clinical data,treatment methods and prognosis were analyzed to understand the clinical characteristics of the disease and the related influencing factors of prognosis.Method:The clinical data of 78 patients with pathologically and immunohistochemically diagnosed gastrointestinal neuroendocrine tumors(GI-NETs)admitted to the First Affiliated Hospital of Dalian Medical University from February 2000 to February 2015 were retrospectively analyzed.Gender,age,tumor size,lymph node metastasis,pathological grade,primary tumor site,T stage,distant metastasis,immunohistochemistry(Syn,Cga and NSE expression),The retrospectivestudyandanalysisofitsclinical characteristicsandprognosticfactors.Results:1.Gender: The group of 78 patients with GI-NETs admitted to the hospital,53 males and 25 females,male to female ratio 2.12: 1;2.Age: The age distribution range of 19-83 years old,with an average age of 56.3 ± 13.7 years;3.Tumor size was 31cases(39.7%)with tumors <1cm,17 cases(21.8%)with 1cm <tumors<2 cm and 30 cases(38.5%)with tumors> 2 cm;.4.The primary site of the tumor(lesion): the most common in the rectum 48 cases(61.5%),followed by the stomach in 11 cases(14.1%),small intestine(including duodenum)in 11 cases(14.1%(T3%),T3(6.4%)and colon(3.9%);5.T stage : 39 patients(50%)in T1 stage,8 patients(10.2%)in T2 stage,(12.8%),and21 cases(27%)in T4 stage;6.The lymph node metastasis was found in 22 patients(28.2%)with lymph node metastasis and 56 patients(71.8%)without lymph node metastasis.7.Situation of metastasis: The most common site of distant metastasis was liver,with distant metastasis in 5 patients(6.4%)and no distant metastasis in 73 patients(93.6%);8.Clinical symptoms: According to the patient's main complaint,functional clinical symptoms(with carcinoid(4 cases,5.1%)(3 cases of rectum and 1 case of duodenum),with diarrhea as the first symptom;74 cases(94.9%)of non-functional clinical symptoms were mainly abdominal pain,bloating and stool Habits and traits of the main change;9.Auxiliary examination: more tips lesion site wall and stomach wall space,thickening,infiltration of the pancreas,appendix thickening and other performance,did not check out the above imaging findings in 47 cases,the proportion of 60.3% of them were diagnosed as imaging diseases,accounting for 39.7% of the total,including 19 cases of intestinal wall lesions,accounting for 24.4%;8 cases of gastric wall lesions,accounting for 10.3%;pancreatic lesions 2 Cases,accounting for 2.5%;appendix lesions in 2 cases,the proportion of 2.5%;10.Pathological classification: 58patients(74.4%)with neuroendocrine tumors(NET),19 patients(24.3%)with neuroendocrine cancer(NEC),mixed glandular neuroendocrine carcinoma(MANEC)One patient(1.3%)(appeared in the appendix);11.Pathological grading: 54(70%)patients with grade G1(carcinoid),4 patients(5%)with G2,and 19 patients(25%)with G3;12.Treatment: Endoscopic EMR or ESD 8 Six patients(87.2%)underwent partial surgical excision,palliative surgery and radical surgery.Two patients(2.6%)who did not undergo surgery after diagnosis were identified;13.Preoperative and postoperative immunohistochemical examination:There were 50 patients(64.1%)in Syn(+),18(23.1%)in Cga(+)patients and 32 patients(41.0%)in NSE(+)patients before and after operation.Among the patients with CD56(+)(19 cases)(24.3%)and CK(+)patients(28cases)(35.9%);14.Prognosis: Sixty-four patients with GI-NETs were followed up for 1 year and 3-year overall survival rates were 96.9% and 73.4%,respectively.Univariate analysis showed that tumor size,lymph node metastasis,pathological grade,primary tumor location,distant metastasis status and T stage were prognostic factors,while gender,age,immunohistochemistry Syn,Cga and NSE expression)had no correlation with prognosis.Multivariate analysis showed that pathological grade was an independent factor affecting the prognosis of patients with GI-NETs.Conclusions:1.In patients with gastrointestinal neuroendocrine tumors,the incidence of male patients is higher than that of female patients and can occur in all age groups;2.Gastrointestinal neuroendocrine tumors occur in the site more than in the rectum,followed by the stomach,small intestine,appendix,colon;3.The clinical symptoms of gastrointestinal neuroendocrine tumors are nonspecific and show less the clinical symptoms of "carcinoid syndrome";4.Most of the pathological types of gastrointestinal neuroendocrine tumors were NET,The main pathological grading was G1(carcinoid)and G2,followed by G3;5.Gastrointestinal neuroendocrine tumors were diagnosed preoperatively and postoperatively by pathological examination or immunohistochemistry,Surgical reatment was often used,including endoscopic resection,local resection,and radical surgery;6.Tumor size,lymph node metastasis,pathological grade,primary tumor location,distant metastasis,T stage are related to the prognosis of patients,while the pathologicalgradeisanindependentriskfactoraffecting theprognosisofpatients. |
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