Tang Caiyun, Gong Lingqi, Zou Wenli, Zhang Jie, Zhou Yuqian, Wu Xiaoping, Lu Fanggen, Ouyang Chunhui, Liu Xiaowei
Department of Gastroenterology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China.
Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China.
Oncol Rep. 2016 Dec;36(6):3343-3352. doi: 10.3892/or.2016.5170. Epub 2016 Oct 13.
Gastroenteropancreatic neuroendocrine tumors (GEP‑NETs) are relatively uncommon. Unfortunately, epidemiological studies on the incidence of GEP‑NETs worldwide have reported a marked increase in the detection of these tumors. Although they often exhibit relatively indolent clinical courses, GEP‑NETs have the potential for lethal progression, especially in patients who present with advanced disease. Early detection and surgical removal is currently the only reliable curative treatment for GEP‑NET patients. The objective of this study was to analyze the clinicopathological characteristics of GEP‑NETs and explore the metastasis‑related risk factors of patients with GEP‑NETs. One hundred and forty‑six patients diagnosed pathologically with GEP‑NETs from January 2001 to January 2015 at the Second Xiangya Hospital of Central South University were retrospectively evaluated. We retrieved and analyzed information concerning clinical characteristics and metastasis‑related risk factors, and used Chi‑square test and logistic regression analysis to analyze the clinicopathological characteristics of GEP‑NETs and explore the association between tumor metastasis and possible related risk factors. The results revealed that the most common clinical manifestations were abdominal pain (n=88), alteration in the character of stool (n=58) and melaena (n=33). Rectum (91/146, 62.3%) and stomach (19/146, 13.0%) were the main sites of metastasis. Both Chi‑square test and logistic regression analysis showed that tumor size (P<0.05), tumor type (P=0.008) and peritumoral lymphatic vessel density (LVD) (P=0.004) were significantly correlated with tumor metastasis. Neither Chi‑square test nor logistic regression analysis indicated that gender (P>0.05), age (P>0.05), tumor location (P>0.05), tumor number (P>0.05), chromaffin granule protein A [chromogranin A (CgA), P>0.05], synaptophysin (Syn, P>0.05) or intratumoral LVD (P>0.05) had a significant correlation with tumor metastasis. Chi‑square test revealed that tumor grade was significantly correlated with tumor metastasis. In conclusion, GEP‑NETs may occur in multiple sites of the digestive system and lack specific clinical manifestations. Tumor size, tumor type, peritumoral LVD, total LVD and tumor grade are metastasis‑related risk factors for GEP‑NET patients.
胃肠胰神经内分泌肿瘤（GEP-NETs）相对不常见。遗憾的是，全球范围内关于GEP-NETs发病率的流行病学研究报告显示，这些肿瘤的检出率显著增加。尽管GEP-NETs通常表现出相对惰性的临床病程，但它们有发生致命进展的可能，尤其是在患有晚期疾病的患者中。早期检测和手术切除目前是GEP-NET患者唯一可靠的治愈性治疗方法。本研究的目的是分析GEP-NETs的临床病理特征，并探讨GEP-NET患者转移相关的危险因素。对2001年1月至2015年1月在中南大学湘雅二医院经病理诊断为GEP-NETs的146例患者进行回顾性评估。我们检索并分析了有关临床特征和转移相关危险因素的信息，并采用卡方检验和逻辑回归分析来分析GEP-NETs的临床病理特征，探讨肿瘤转移与可能相关危险因素之间的关联。结果显示，最常见的临床表现为腹痛（n = 88）、大便性状改变（n = 58）和黑便（n = 33）。直肠（91/146，62.3%）和胃（19/146，13.0%）是主要转移部位。卡方检验和逻辑回归分析均显示，肿瘤大小（P < 0.05）、肿瘤类型（P = 0.008）和瘤周淋巴管密度（LVD）（P = 0.004）与肿瘤转移显著相关。卡方检验和逻辑回归分析均未表明性别（P > 0.05）、年龄（P > 0.05）、肿瘤位置（P > 0.05）、肿瘤数量（P > 0.05）、嗜铬粒蛋白A [嗜铬粒蛋白A（CgA），P > 0.05]、突触素（Syn，P > 0.05）或瘤内LVD（P > 0.05）与肿瘤转移有显著相关性。卡方检验显示肿瘤分级与肿瘤转移显著相关。总之，GEP-NETs可能发生于消化系统的多个部位且缺乏特异性临床表现。肿瘤大小、肿瘤类型、瘤周LVD、总LVD和肿瘤分级是GEP-NET患者转移相关的危险因素。
