胃神经内分泌癌23例临床病理特点和诊治分析

Clinico-pathological characteristics and clinical features analysis of 23 patients with gastric neuroendocrine carcinoma

目的探讨胃神经内分泌癌(gastric neuroendocrine carcinoma,G⁃NEC)的临床病理和诊治特点以及预后分析。方法回顾性分析六安市人民医院普外科2011年3月至2018年3月收治的23例G⁃NEC病人临床资料,分析病人的临床表现及诊治经过,利用术后病理学及免疫组化确定诊断,观察并利用Kaplan⁃Meier法绘制生存曲线。结果23例G⁃NEC中男16例,女7例,占同期收治胃癌的人数的1.2%,中位年龄64岁,其中胃上部癌10例,胃中部癌6例,胃下部癌7例,行R0切除者19例,R1切除者2例,姑息性切除者2例,随访生存时间为7~84月,中位生存时间为28月,1、3、5年生存率分别为86.5%、37.9%、9.5%。结论胃神经内分泌癌是一类侵袭性强、恶性程度高、预后较差的少见肿瘤,发病率及术前诊断率较低,确诊依赖于术后病理学及免疫组化,外科手术可使病人生存获益,手术是首选治疗方案,综合治疗在其治疗中起到重要作用。

Objective To evaluate the clinico⁃pathological characteristics,Clinical feature,diagnosistreatment and prognosis of gas⁃tric neuroendocrine carcinoma(G-NEC).Methods Clinical data of 23 G-NEC cases were collected in the Department of Abdomi⁃nal Surgery at the Department of Surgery,Lu’An Affiliated Hospital of Anhui Medical University between July 2011 and March 2018.Its diagnosis relies on pathological examination and immunohistochemistry.Follow⁃up was conducted by telephone,The surviv⁃al curves were drawn using Kaplan⁃Meier method.Results G-NEC of the stomach accounted for 1.2%of all the gastric carcino⁃mas.The tumor occurred moreoften in males(17 of 23),older patients(mean age of 64 years).19 p.atients underwent curative resec⁃tion(R0),while 2 underwent palliative resection and 2 others underwent R1 resection.The median overall survival rate was 28months(range7 to 84 months),and the overall 1,3,5⁃year survival rates were 86.5%,37.9%and9.5%respectively.Conclusions G-NEC is a highly malignant tumor with poor prognosis.Preoperative diagnosis rate is low,Its diagnosis relies on pathological exam⁃ination and immunohistochemistry.Tumor T stage have potential impact on survival.Surgery is the treatment of first choice,while the choice of comprehensive treatment after surgery should be optimized.