97例胃肠胰神经内分泌肿瘤临床特征与预后分析

Gastroenteropancreatic neuroendocrine neoplasms: a clinical analysis of 97 cases

目的探讨胃肠胰神经内分泌肿瘤(gastroenteropancreatic neuroendocrine neoplasms,GEP-NEN)的临床特征以及预后,为进一步认识该病提供帮助。方法回顾性分析2011年12月~2015年12月期间由安徽医科大学第一附属医院收治的97例GEP-NEN患者的临床以及随访资料。结果 97例患者中,男性患者数量为女性患者1.9倍(64∶33)。发病部位最常见于胃(40.2%)和直肠(25.8%)。GEP-NEN缺乏特异性症状,其主要症状还是腹痛、腹胀等消化道一般常见症状。肿瘤标记物嗜铬颗粒蛋白A和突触素的阳性率高,分别为87.6%、96.9%。Cox比例风险回归分析中,发现除常见的肿瘤分级、浸润深度及淋巴转移是GEP-NEN患者生存的影响因素外(均有P<0.05),性别及不同的手术方式对患者预后也有影响(均有P<0.05)。结论 GEP-NEN是一种少见的疾病,消化道任何部位均可出现,临床表现没有特异性,给术前诊断带来困难,很多病例确诊时已是晚期。治疗以手术为主,总体预后较好。随访1、3年生存率分别为81.9%和63.4%。

Objective To investigate the clinical characteristics,treatments and relationship with survival of gastroenteropancreatic neuroendocrine neoplasms （GEP-NEN）,so as to provide knowledge for further understanding of this disease.Methods The clinical data of the 97 GEP-NEN patients admitted in the First Affiliated Hospital of Anhui Medical University from December 2011 to December 2015 were retrospectively analyzed.Results Of the 97 patients,64 cases were males and 33 were females,the male-to-female ratio was 1.9：1.There were 39 cases （40.2%） occurred in the stomach and 25 cases （25.8%） in rectum.Of all the 97 cases,non-functional symptom accounted for 95.9% （93/97）,while functional symptom accounted only for 4.1% （4/97）.The positive rate of immunohistochemical diagnosis of chromogranin A and synaptophysin were 87.6%,96.9%,respectively.The multivariate analysis showed that risk factors of reducing survival rate include pathological grading,infiltrating extent and lymph node metastasis （all P 〈 0.05）,as well as surgical methods and gender （all P 〈 0.05）.Conclusions GEP-NEN may be found at any part of digestive system.Preoperative diagnosis is difficult and a lot of confirmed cases is already late.The treatment of this tumor mainly depends on the operation.The overall prognosis is good.The 1-and 3-year survival rates were 81.9% and 63.4%,respectively.