Wu Fan, Li Peng, Zhao Hong, Liu Shangmei, Guo Chunguang, Wang Yang, Zhao Dongbing
Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China. Email:
Zhonghua Yi Xue Za Zhi. 2014 Apr 29;94(16):1237-40.
To analyze the prognostic factors and long-term surgical efficacies of rectal neuroendocrine neoplasm (NEN).
The clinical and pathological data of 141 patients with rectal NENs treated between January 1999 and November 2012 were retrospectively analyzed. The Kaplan-Meier method was used to calculate survival time and Cox regression to analyze the clinicopathological factors correlating with patient prognosis.
The overall 1, 3 and 5-year survival rates were 95.4%, 87.0% and 82.8% respectively. According to the criteria of WHO classification (2010) and staging system about rectal NEN, there were grade 1 (G1) (n = 76, 79.2%), grade 2 (G2) (n = 12, 12.5%), neuroendocrine carcinoma (NEC) (n = 7, 7.3%) and mixed adenoneuroendocrine carcinoma (n = 1, 1.0%), the 1, 3 and 5-year survival rates were 98.6%, 43.7%,0% and 100.0% respectively. There were stage I (n = 71, 74.0%) , stage II (n = 5, 5.2%), stage III (n = 12, 12.5%) and stage IV (n = 8, 8.3%) . The 1, 3 and 5-year survival rates were 97.7%, 75.0%, 57.1% and 25.0% respectively.Univariate analysis showed that tumor diameter, histological grade, lymph node metastasis, distant metastasis, radical surgery and muscular layer invasion significantly affected the postoperative survival. And Cox multivariate analysis indicated that tumor diameter and histological grade were independent prognostic factors.
Rectal NENs vary significantly in their prognoses.However, radical surgery offers satisfactory long-term survival rates. An optimal surgical approach should be selected based on tumor size. And more radical surgery should be performed for neuroendocrine tumors >2 cm.
分析直肠神经内分泌肿瘤（NEN）的预后因素及长期手术疗效。
回顾性分析1999年1月至2012年11月期间接受治疗的141例直肠NEN患者的临床和病理资料。采用Kaplan-Meier法计算生存时间，Cox回归分析与患者预后相关的临床病理因素。
总体1年、3年和5年生存率分别为95.4%、87.0%和82.8%。根据世界卫生组织（WHO）2010年直肠NEN分类标准和分期系统，有1级（G1）（n = 76，79.2%）、2级（G2）（n = 12，12.5%）、神经内分泌癌（NEC）（n = 7，7.3%）和混合性腺神经内分泌癌（n = 1，1.0%），其1年、3年和5年生存率分别为98.6%、43.7%、0%和100.0%。有Ⅰ期（n = 71，74.0%）、Ⅱ期（n = 5，5.2%）、Ⅲ期（n = 12，12.5%）和Ⅳ期（n = 8，8.3%），其1年、3年和5年生存率分别为97.7%、75.0%、57.1%和25.0%。单因素分析显示肿瘤直径、组织学分级、淋巴结转移、远处转移、根治性手术和肌层浸润显著影响术后生存。Cox多因素分析表明肿瘤直径和组织学分级是独立的预后因素。
直肠NEN的预后差异显著。然而，根治性手术可提供令人满意的长期生存率。应根据肿瘤大小选择最佳手术方式。对于直径>2 cm的神经内分泌肿瘤，应进行更彻底的手术。
