218例神经内分泌肿瘤流行病学及病理学特征分析

Epidemiology and clinicopathological characteristics of 218 cases of neuroendocrine neoplasms

目的:分析河南地区神经内分泌肿瘤(neuroendocrine neoplasm,NEN)的流行病学和病理学特征,为NEN的防治提供依据。方法:回顾性调查2010年1月至2015年12月经河南省人民医院病理科确诊的NEN患者,综合分析其流行病学及病理学特征。结果:共检出NEN患者218例,总检出率为0.09%;年检出率的差异具有统计学意义(P<0.05);男性117例,女性101例,比例为1.16∶1;平均年龄(51.19±13.97)岁,男性平均年龄(52.86±13.10)岁,女性平均年龄(49.24±14.76)岁。三种病理类型中神经内分泌瘤(NET)104例(47.71%),神经内分泌癌(NEC)107例(49.08%),混合性腺神经内分泌癌(MANEC)7例(3.21%),不同性别NEN的病理类型差异无统计学意义(P>0.05)。NEN高发年龄为40~69岁,不同年龄段的NET和NEC差异有统计学意义(P<0.05)。病变部位以胰腺(22.02%)最为常见,其次为肺(15.14%),小脑、鼻、喉部、宫颈、卵巢等其他部位较罕见,除甲状腺外,不同性别在病变部位上的差异无统计学意义(P>0.05)。肿瘤组织标本的取得方式中以传统的手术为主(51.38%),其次是内镜方式(44.49%)。嗜铬蛋白A(CgA)染色阳性156例(71.56%);突触素(SYN)染色阳性203例(93.12%);NET、NEC中SYN阳性率均高于CgA阳性率,差异具有统计学意义(P<0.05)。结论:河南地区NEN的检出率近年呈上升趋势,熟悉其流行病学和病理学特征对早期诊断、防治及降低该地区NEC的发生具有重要的意义。

Objective:To analyze the epidemiological and clinicopathologic characteristics of neuroendocrine neoplasm(NEN) in Henan Provincial People's Hospital,to provide evidences for prevention and treatment of NEN.Methods:We retrospectively reviewed all pathologic diagnosed neuroendocrine neoplasms patients in People's Hospital of Zhengzhou University(Henan Provincial People's Hospital) from January 2010 to December 2015.The epidemiology characteristics,pathogenic sites and pathological types were reviewed.Results:There were 218 cases of patients with NEN,including 117 males and 101 females(male ∶female=1.16 ∶1).The total detection rate was 0.09%.The annual detection rate was statistically significant difference( P <0.05).The mean age of all cases was (51.19±13.97) years,for male (52.86±13.10) years and female (49.24±14.76) years.There were 104(47.71%) cases of neuroendocrine tumor(NET),107(49.08%) cases of neuroendocrine carcinoma(NEC),7(3.21%) cases of mixed adenocarcinoma(MANEC) in this clinical series.There was no statistical significance of pathological types between male and female( P >0.05).NEN has a higher incidence rate in person aged 40 to 69 years.There was statistical significance of pathological types between age groups.Pancreas was the most common occurred site of NEN(22.02%),then was the respiratory system(15.14%),and brain,nose,pharyngeal,cervical and ovarian lesions were rare.There was no statistical significance of pathogenic sites between male and female beside thyroid( P >0.05).Most tumor tissue samples were acquired by traditional surgery(51.38%),followed by endoscopic methods(44.49%).Chromogranin(CgA) staining was positive in 156 cases(71.56%),synaptophysin(SYN) staining positive in 203(93.12%).SYN positive rate were higher than CgA in NET and NEC with statistically significant difference( P <0.05).Conclusion:The detection rate of NEN in Henan Province is on the rise in recent years.Knowledge of the epidemiology and clinical pathological features for the early diagnosis,treatment and reducing the incidence of NEC in the area is of great significance.