胃肠胰神经内分泌肿瘤的临床特征及预后因素：中国单中心经验

Clinical characteristics and prognostic factors of gastroenteropancreatic neuroendocrine tumors: a single center experience in China.

作者信息

Hu Han-kui, Ke Neng-wen, Li Ang, Du Xiao-jiong, Guo Qiang, Hu Wei-ming

出版信息

Hepatogastroenterology. 2015 Jan-Feb;62(137):178-83.

Abstract

BACKGROUND/AIMS: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a unique subgroup of tumors in the digestive system but with great clinical heterogeneity. The information on clinical characteristics and prognostic factors of Chinese patients is rather limited.

METHODOLOGY

We retrospectively analyzed the clinical features, prognostic factors of this disease in a consecutive cohort (N=294) between January 2007 and December 2012.

RESULTS

Functioning tumors accounted for 9.2%. Rectum was the most predominant GEP-NETs locations. Abdominal pain occurred in 46.5% patients which was the most common initial symptom. G1, G2 and G3 tumors accounted for 41.5%, 34.7% and 23.8%, respectively. Endoscopy provided the highest detection rate of 95.7%. Consistence between endoscopic ultrasound guided fine needle aspiration biopsy (EUS-FNAB) and surgically obtained histological Ki-67 index was 36.4%. Serum CgA test showed a 80.0% consistence with the tissue biopsy. The median follow up duration was 2.8 years (0.02-5.90 years), the median survival was 4.8 years, overall 5-year survival rate was 69.6%. We found colonic localization, tumor size larger than 20 mm, G3 tumor and metastasis were associated with worse outcome (p<0.05).

CONCLUSION

We found both consistence and differences in GEP-NETs characteristics between our study and previous reports.

摘要

背景/目的：胃肠胰神经内分泌肿瘤（GEP-NETs）是消化系统中一类独特的肿瘤亚群，但具有很大的临床异质性。关于中国患者临床特征和预后因素的信息相当有限。

方法

我们回顾性分析了2007年1月至2012年12月期间连续队列（N = 294）中该疾病的临床特征和预后因素。

结果

功能性肿瘤占9.2%。直肠是GEP-NETs最主要的发病部位。46.5%的患者出现腹痛，这是最常见的初始症状。G1、G2和G3肿瘤分别占41.5%、34.7%和23.8%。内镜检查的检出率最高，为95.7%。内镜超声引导下细针穿刺活检（EUS-FNAB）与手术获得的组织学Ki-67指数的一致性为36.4%。血清嗜铬粒蛋白A（CgA）检测与组织活检的一致性为80.0%。中位随访时间为2.8年（0.02 - 5.90年），中位生存期为4.8年，总体5年生存率为69.6%。我们发现结肠定位、肿瘤大小大于20 mm、G3肿瘤和转移与较差的预后相关（p<0.05）。