Li Yuan, Bi Xinyu, Zhao Jianjun, Huang Zhen, Zhou Jianguo, Li Zhiyu, Zhang Yefan, Li Muxing, Chen Xiao, Hu Xuhui, Chi Yihebali, Zhao Dongbing, Zhao Hong, Cai Jianqiang
From the Department of Abdominal Surgery (YL, XB, Jianjun Zhao, ZH, Jianguo Zhou, ZL, YZ, ML, XC, XH, DZ, HZ, JC); and Department of Medical Oncology (YC), Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China .
Medicine (Baltimore). 2016 May;95(18):e3567. doi: 10.1097/MD.0000000000003567.
Gastrin-independent gastric neuroendocrine tumors (GNETs) are highly malignant. Radical resections and lymphadenectomy are considered to be the only possible curative treatment for these tumors. However, the prognosis of gastrin-independent GNETs is not well defined. In this study, we identified prognostic factors of locoregional gastrin-independent GNETs.All patients diagnosed with locoregional gastrin-independent GNETs between 2000 and 2014 were included in this retrospective study. Clinical characteristics, blood tests, pathological characteristics, treatments, and follow-up data of the patients were collected and analyzed.Of the 66 patients diagnosed with locoregional gastrin-independent GNETs, 57 (86.4%) received radical resections, 7 (10.6%) with palliative resection, 1 (1.5%) with gastrojejunostomy, and 1 (1.5%) with exploration surgeries. The median survival time for these patients was 19.0 months (interquartile range, 11.0-38.0). The 1-, 3-, and 5-year survival rates were 72%, 34%, and 28%, respectively. Multivariate analysis indicated that carcinoembryonic antigen (CEA) level (P = 0.04), radical resection (P = 0.04), and positive Cluster of Differentiation 56 (CD56) expression (P = 0.016) were significant prognostic factors on overall survival rate. Further univariate and multivariate analysis of 57 patients who received radical resections found that CgA expression (P = 0.35) and CEA level (P = 0.33) are independent prognostic factors.Gastrin-independent GNETs had poor prognosis. Serum CEA level, radical surgery, CD56 and CgA expression are markers to evaluate the survival of patients with locoregional gastrin-independent GNETs.
胃泌素非依赖性胃神经内分泌肿瘤（GNETs）具有高度恶性。根治性切除和淋巴结清扫被认为是这些肿瘤唯一可能的治愈性治疗方法。然而，胃泌素非依赖性GNETs的预后尚不明确。在本研究中，我们确定了局限性胃泌素非依赖性GNETs的预后因素。
本回顾性研究纳入了2000年至2014年间所有诊断为局限性胃泌素非依赖性GNETs的患者。收集并分析了患者的临床特征、血液检查、病理特征、治疗方法及随访数据。
在66例诊断为局限性胃泌素非依赖性GNETs的患者中，57例（86.4%）接受了根治性切除，7例（10.6%）接受了姑息性切除，1例（1.5%）接受了胃空肠吻合术，1例（1.5%）接受了探查手术。这些患者的中位生存时间为19.0个月（四分位间距，11.0 - 38.0）。1年、3年和5年生存率分别为72%、34%和28%。多因素分析表明，癌胚抗原（CEA）水平（P = 0.04）、根治性切除（P = 0.04）和分化簇56（CD56）表达阳性（P = 0.016）是总体生存率的显著预后因素。对57例接受根治性切除的患者进行进一步的单因素和多因素分析发现，嗜铬粒蛋白A（CgA）表达（P = 0.35）和CEA水平（P = 0.33）是独立的预后因素。
胃泌素非依赖性GNETs预后较差。血清CEA水平、根治性手术、CD56和CgA表达是评估局限性胃泌素非依赖性GNETs患者生存情况的指标。
