Xu Tian Ming, Wang Chun Sai'er, Jia Cong Wei, Qian Jia Ming, Li Jing Nan
Department of Gastroenterology, Beijing, 100730, China.
Department of Pathology, Peking Union Medical College Hospital, Beijing, 100730, China.
J Dig Dis. 2016 Mar;17(3):162-8. doi: 10.1111/1751-2980.12326.
To assess the clinical characteristics, diagnosis and therapeutic modalities for gastric neuroendocrine neoplasms (GNENs) among the Chinese population in a single institution.
A total of 57 patients with histologically confirmed GNENs, who were diagnosed between 1995 and 2015 at the Peking Union Medical College Hospital were retrospectively reviewed. The clinical, imaging and histopathologic characteristics as well as the treatments of GNENs were collected and analyzed.
Patients with GNENs mostly presented with non-specific symptoms. Gastric body was the most common site of involvement. The choice of imaging modality, such as endoscopy and computed tomography depended on the tumor subtype. Chromogranin A (CgA) and synaptophysin were indispensable immunohistochemical markers for diagnosis. Significant inter-group differences in the positivity rate of CD56 were observed among the three grades (G1, G2 and G3). Therapeutic modalities included endoscopic intervention, surgical resection and pharmacotherapy, which were largely guided by the tumor subtype and the presence or absence of distant metastasis or tumor recurrence.
Routine endoscopic examination is recommended for the early diagnosis of GNENs. Histopathological examination can make the definite diagnosis of GNENs and clarify the nature of gastric polyps. A multidisciplinary approach is important in the management of patients with GNENs.
评估单机构中中国人群胃神经内分泌肿瘤(GNENs)的临床特征、诊断及治疗方式。
回顾性分析1995年至2015年间在北京协和医院确诊的57例经组织学证实的GNENs患者。收集并分析GNENs的临床、影像及组织病理学特征以及治疗情况。
GNENs患者大多表现为非特异性症状。胃体是最常受累部位。成像方式(如内镜检查和计算机断层扫描)的选择取决于肿瘤亚型。嗜铬粒蛋白A(CgA)和突触素是诊断必不可少的免疫组化标志物。在三个分级(G1、G2和G3)中,CD56阳性率存在显著组间差异。治疗方式包括内镜干预、手术切除和药物治疗,主要依据肿瘤亚型以及是否存在远处转移或肿瘤复发来指导。
建议对GNENs进行常规内镜检查以早期诊断。组织病理学检查可明确GNENs诊断并阐明胃息肉的性质。多学科方法对GNENs患者的管理很重要。