Clinicopathological Characteristics Of Type ? G-NENs And Analysis Of Risk Factors Affecting Postoperative Recurrence

Objective: To explore the clinicopathological characteristics of type ? G-NENs and the risk factors affecting postoperative recurrence.Methods: The clinicopathological characteristics and follow-up data of 69 patients who received radical gastrectomy in the Fourth Hospital of Hebei Medical University from January 1,2013 to December 31,2017 and the pathology confirmed the diagnosis of type ? G-NENs were retrospectively analyzed.Type ? G-NENs was classified into G-NEC and G-MANEC according to the WHO pathological grading standard in 2010.SPSS 25.0 was used for analysing clinicopathological characteristics of type ? G-NENs and comparing the clinicopathological characteristics of G-NEC and G-MANEC.Univariate and multivariate analysis were used to screen the risk factors of postoperative recurrence.Results:1.Type ? G-NENs was common in middle aged and elder men,and the first symptoms were mostly general digestive symptoms.The lesions were mostly located at the cardiac and gastric fundus,and the maximum diameter of the tumor was mostly more than 3.5cm.Most patients have late staging and lymph node metastasis.About half of the patients have vascular tumor thrombus and nerve invasion.The clinicopathological characteristics of G-NEC and G-MANEC were not significantly different.2.Multivariate analysis of type ? G-NENs suggested pathological grade(P=0.014)and adjuvant chemotherapy(P=0.000)were independent risk factors for recurrence.The risk of recurrence in patients with G-NEC was 2.9 times higher than G-MANEC,and in patients without adjuvant chemotherapy was 5.9 times higher than patients receiving chemotherapy.Stratified analysis: multivariate analysis of patients with G-NEC suggested adjuvant chemotherapy(P=0.012)was an independent risk factor for recurrence.The risk of recurrence in patients without adjuvant chemotherapy was 6.6 times higher than patients receiving chemotherapy.It was found in the multivariate analysis of patients with G-MANEC that adjuvant chemotherapy(P=0.003)was an independent risk factor for recurrence.The risk of recurrence in patients without adjuvant chemotherapy was 7.5 times higher than patients receiving chemotherapy.The effect of EP and SOX regimens on postoperative recurrence of patients with type ? G-NENs and G-MANEC were not significantly different.Conclusions:1.Type ? G-NENs are common in middle aged and elder men,and their clinical manifestations are more atypical.Patients have late staging and more prone to lymph node metastasis.The clinicopathological characteristics of G-NEC and G-MANEC are similar.2.Patients with G-NEC are more susceptible to recurrence than with G-MANEC.3.Patients with type ? G-NENs receiving adjuvant chemotherapy can improve the prognosis.4.The effect of adjuvant chemotherapy with EP and SOX regimens on type ? G-NENs and G-MANEC patients has no difference.