Analysis Of Clinical And Pathological Features Of The Rectal Neuroendocrine Neoplasms

ObjectiveNeuroendocrine tumors(NENs)are derived from peptidergic neurons and neuroendocrine cells that can occur in all organs and tissues of the body.Gastro-intestinal tract is the most frequent location of NENs,of which the incidence of rectal NENs is the highest.Currently,there is little study in clinical distribution and pathological features of the rectal NENs.MethodsThe patients undergoing surgical treatment in gastrointestinal surgery at Qianfoshan Hospital from January 2005 to August 2015 were selected,and all the patients suffering from rectal NENs including neuroendocrine tumors,neuroendocrine carcinoma and mixed adenoneuroendocrine carcinoma,made definite diagnoses by pathological examination with postoperative specimens.The data of the patient's gender,age,tumor site,clinical symptoms,preoperative auxiliary examination,treatment and postoperative pathological results were collected to conduct retrospective analysis.The clinical distribution and pathological features of rectal NENs patients were investigated by statistical analysis.ResultsIn this study,a total of 50 patients were composed of 36 males(72%)and 14 females(28%),and there was no significant difference in terms of age between the two groups.The patients had different symptoms at the diagnosis,including no clinical symptoms in 26% of the patients,hematocheziain 22% of the patients and anal symptoms,change in bowel habit,abdominal pain as well as diarrhea in the remaining patients.Approximately half of the patients had the tumors with maximum diameter less than 1cm.Additionally,we found that the tumor location was associated with tumor maximum diameter.The tumor maximum diameter at lower rectal(1.77±0.92cm)was longer than that at the middle of the rectum(1.29±0.75cm)and upper rectal(1.10±0.22cm),but statistical difference was only observed between the tumor maximum diameters at lower rectal and upper rectal(P=0.009).However,there were no significant differences between the tumor maximum diameters at every rectal wall.In addition,we performed the correlation analysis of tumor classification with the tumor diameter,and found that there was a positive correlation with correlation coefficient of 0.435(P=0.002),but no significant correlation was seen between tumor classification and patient age.This study also conducted pathological specimens staining with Syn and CgA,and observed that the sensitivity with Syn staining was higher than CgA staining at the diagnosis of rectum NENs,indicating that the clinical application of Syn staining will contribute to improving the detection rate of rectal NENs.ConclusionThe incidence of rectal NENs was higher in male patients than female patients.Approximately half of the patients were diagnosed with no clinical symptoms or hematochezia.Most tumor volumes were small,and the tumor maximum diameters were less than 1cm.We found that the tumor location was associated with tumor maximum diameter.The tumor maximum diameter at lower rectum was longer than that at the middle of the rectum and upper rectal.In addition,tumor classification was positively correlated with the tumor maximum diameter rather than the patient age.Our results also showed that the sensitivity with Syn staining was significantly higher than CgA staining at the diagnosis of rectum NENs.Therefore,fully understanding the clinical distribution and pathological features of rectal NENs will contribute to improving the levels of clinical diagnosis and treatment.