Chi Yihebali, Du Feng, Zhao Hong, Wang Jin-Wan, Cai Jian-Qiang
Yihebali Chi, Feng Du, Hong Zhao, Jin-Wan Wang, Jian-Qiang Cai, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China.
World J Gastroenterol. 2014 Nov 21;20(43):16252-7. doi: 10.3748/wjg.v20.i43.16252.
To analyze the clinicopathologic characteristics and prognostic factors of rectal neuroendocrine tumors.
The records of 48 patients with rectal neuroendocrine tumors who were treated at the Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, from March 2004 to September 2009 were retrospectively reviewed. The clinicopathological data were extracted and analyzed, and patients were followed-up by telephone or follow-up letter to determine their survival status. Follow-up data were available for all 48 patients. Uni- and multivariate Cox regression analyses were performed to determine the prognostic factors significantly associated with overall survival.
The tumors occurred mostly in the middle and lower rectum, and the most prominent symptoms experienced by patients were hematochezia and diarrhea. The median distance between the tumors and the anal edges was 5.0 ± 2.257 cm, and the median diameter of the tumors was 0.8 ± 1.413 cm. The major pathological type was a typical carcinoid tumor, which accounted for 93.8% (45/48) of patients. Tumor-node-metastasis (TNM) stages I, II, III and IV tumors accounted for 78.8%, 3.9%, 9.6% and 7.7% of patients, respectively. The main treatment method, in 72.9% (35/48) of patients, was transanal extended excision. The 1-, 3- and 5-year survival rates of the whole group of patients were 100%, 93.7%, and 91.3%, respectively. Univariate analysis showed that age (P = 0.032), tumor diameter (P < 0.001), histological type (P < 0.001), TNM stage (P < 0.001), and surgical approach (P = 0.002) were all prognostic factors. On multivariate analysis, only the pathological type was shown to be an independent prognostic factor (HR = 2.797, 95%CI: 1.676-4.668, P = 0.004).
In patients with rectal neuroendocrine tumors, TNM stage I is the most common stage found, and lymph node or distant metastases are rarely seen. The pathological type of the tumor is an independent prognostic factor.
分析直肠神经内分泌肿瘤的临床病理特征及预后因素。
回顾性分析2004年3月至2009年9月在中国医学科学院肿瘤医院接受治疗的48例直肠神经内分泌肿瘤患者的病历。提取并分析临床病理数据，通过电话或随访信对患者进行随访以确定其生存状态。48例患者均有随访数据。进行单因素和多因素Cox回归分析以确定与总生存显著相关的预后因素。
肿瘤多发生于直肠中下段，患者最突出的症状为便血和腹泻。肿瘤距肛缘的中位距离为5.0±2.257cm，肿瘤的中位直径为0.8±1.413cm。主要病理类型为典型类癌肿瘤，占患者的93.8%（45/48）。肿瘤-淋巴结-转移（TNM）分期I、II、III和IV期肿瘤分别占患者的78.8%、3.9%、9.6%和7.7%。72.9%（35/48）的患者主要治疗方法为经肛门扩大切除术。全组患者的1年、3年和5年生存率分别为100%、93.7%和91.3%。单因素分析显示年龄（P = 0.032）、肿瘤直径（P < 0.001）、组织学类型（P < 0.001）、TNM分期（P < 0.001）和手术方式（P = 0.002）均为预后因素。多因素分析显示，仅病理类型为独立预后因素（HR = 2.797，95%CI：1.676 - 4.668，P = 0.004）。
直肠神经内分泌肿瘤患者中，TNM分期I期最为常见，很少见淋巴结或远处转移。肿瘤的病理类型是独立的预后因素。
