Analyisis Of Clinical Treatment And Prognosis Of 24 Patients With Colorectal Neuroendocrine Tumors

Objective:To investigate the clinical manifestations,pathological features,diagnosis,treatment and prognosis of colorectal neuroendocrine tumor.Methods:The clinical data of 24 patients with colorectal neuroendocrine tumors from the first affiliated hospital of chongqing medical university between December 2013 and March 2019 was collected and retrospectively analyzed.Results:Colorectal neuroendocrine tumors included in this study 24 patients,12 patients were male and 12 patients were females,the average age of 54.75 ±14.31,41~50 years old patients accounted for 29.17%,and patients aged over 40 years accounted for 83.33%.The first symptoms wereanal flatulence in six cases,diarrhea in 4 cases,hematochezia in 4cases,physical examination findings in 4 cases,2 cases of abdominal distension pain,2 cases of difficulty in defecation,and 2 cases of change in stool habits.In 24 cases of colorectal tumor,19 cases in the rectum,4 cases happend in colon,and 1 case happend in both rectum and colon.15 patients with tumor diameter < 2cm,9 patients with tumor diameter > 2cm.There were 11 cases of grade G1,4 cases of grade G2,6 cases of grade G3 and 3cases of MANEC.Chromogranin a(Cga)immunohistochemical staining was positive in 14 cases(58.33%),Synaptophyin(Syn)mmunohistochemicalstaining was positive in 23 cases(95.83%).Among the 24 patients,18 cases accepted radical resection(including endoscopic submucosal dissection and surgery radical resection),2cases accepted palliative tumor reduction surgery,and 4 received conservative treatment.All the 13 patients who were in stage I survived,including 1case with postoperative recurrence of rectal neuroendocrine carcinoma(G3)in stage III.Among 5 patients in stage III,2 patients died due to tumor recurrence and metastasis after radical resection,1 patient who only oral yew capsule adjuvant treatment after diagnosis died within 4 months,and the other 2 patients survived.Among11 patients in stage III or above,the 3-year survival rate was 59.65%.Conclusion:Colorectal neuroendocrine neoplasms have no specific clinical manifestations and no significant difference in sex.Definite diagnosis requires pathological examination.Surgical treatment is the primary treatment,adjuvant chemotherapy can not improve the prognosis of patients who have accepted radical resection.Tumors diameter,proliferative activity,staging are related to the prognosis.