胃神经内分泌肿瘤150例的临床特征及预后分析

Analysis of clinicopathological features and prognosis of 150 patients with gastric neuroendocrine neoplasm

目的分析胃神经内分泌肿瘤(GNENs)的临床病理学特征及预后相关因素。方法回顾性分析2006年11月至2020年9月南京大学医学院附属鼓楼医院收治的150例GNENs患者的临床病理资料,分析其临床病理学特征及预后相关因素。结果150例胃神经内分泌肿瘤中NET 70例(46.7%)、NEC 44例(29.3%)、MiNEN 36例(24.0%),NEC和MiNEN易出现淋巴结转移和远处转移,以Ⅲ、Ⅳ期为主。三组在年龄、性别、肿瘤直径、肿瘤个数、病理分级、淋巴结转移、远处转移、AJCC方面的差异均有显著的统计学意义(P<0.001)。Kaplan-Meier曲线显示NET、NEC和MiNEN 3年疾病特异生存率分别为93.8%、26.0%、48.0%,差别具有统计学意义。多因素COX回归分析显示AJCC分期、远处转移是影响预后的独立因素(P<0.05)。结论年龄、性别、肿瘤个数、肿瘤直径、病理分级、病理分类、AJCC分期、是否淋巴结转移、是否远处转移是影响GNENs患者预后的因素,AJCC分期、是否远处转移是GNENs患者预后的独立影响因素。

Objective To analyze clinicopathological features and relevant prognostic factors of 150 cases of gastric neuroendocrine neoplasms.Methods The 150 patients with GNENs were collected between November 2006 to September 2020 from Nanjing Drum Tower Hospital,we retrospectively analyzed their clinicopathological features and relevant prognostic factors.ResultsAmong 150 cases of GNENs,NET,NEC,and MiNEN were 70,44,and 36 cases,respectively.NEC and MiNEN were prone to lymph node metastasis and distant metastasis,mainly stageⅢandⅣ.The three groups of patients had significant differences in age,gender,tumor diameter,tumor number,pathological grade,lymph node metastasis,distant metastasis,and AJCC stage(P<0.001).The Kaplan-Meier curve showed that the 3-year disease-specific mortality of NET,NEC and MiNEN were 93.8%,26.0%,and 48.0%,respectively,and the difference was statistically significant.Univariate survival analysis showed that age,gender,tumor number,tumor diameter,pathological grade,pathological classification,AJCC stage,lymph node metastasis,and distant metastasis were related to prognosis(P<0.05).The results of multivariate COX regression analysis showed that AJCC stage,and distant metastasis were independent prognostic factors for GNENs patients(P<0.05).Conclusion Age,gender,tumor number,tumor diameter,pathological grade,pathological classification,AJCC stage,lymph node metastasis,and distant metastasis were the factors affecting the prognosis of patients with GNENs.AJCC stage and distant metastasis were the independent factors influencing the prognosis of patients with GNENs.