Jiang Mengjie, Tan Yinuo, Li Xiaofen, Fu Jianfei, Hu Hanguang, Ye Xianyun, Cao Ying, Xu Jinghong, Yuan Ying
Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Gastroenterol Res Pract. 2017;2017:4206172. doi: 10.1155/2017/4206172. Epub 2017 Jan 17.
. Limited research is available regarding colorectal NENs and the prognostic factors remain controversial. . A total of 68 patients with colorectal NENs were studied retrospectively. Clinical characteristics and prognosis between colonic and rectal NENs were compared. The Cox regression models were used to evaluate the predictive capacity. . Of the 68 colorectal NENs patients, 43 (63.2%) had rectal NENs, and 25 (36.8%) had colonic NENs. Compared with rectal NENs, colonic NENs more frequently exhibited larger tumor size ( < 0.0001) and distant metastasis ( < 0.0001). Colonic NENs had a worse prognosis ( = 0.027), with 5-year overall survival rates of 66.7% versus 88.1%. NET, NEC, and MANEC were noted in 61.8%, 23.5%, and 14.7% of patients, respectively. Multivariate analyses revealed that tumor location was not an independent prognostic factor ( = 0.081), but tumor size ( = 0.037) and pathological classification ( = 0.012) were independent prognostic factors. . Significant differences exist between colonic and rectal NENs. Multivariate analysis indicated that tumor size and pathological classification were associated with prognosis. Tumor location was not an independent factor. The worse outcome of colonic NENs observed in clinical practice might be due not only to the biological differences, but also to larger tumor size in colonic NENs caused by the delayed diagnosis.
关于结直肠神经内分泌肿瘤的研究有限,且预后因素仍存在争议。对68例结直肠神经内分泌肿瘤患者进行了回顾性研究。比较了结肠和直肠神经内分泌肿瘤的临床特征及预后。采用Cox回归模型评估预测能力。在68例结直肠神经内分泌肿瘤患者中,43例(63.2%)为直肠神经内分泌肿瘤,25例(36.8%)为结肠神经内分泌肿瘤。与直肠神经内分泌肿瘤相比,结肠神经内分泌肿瘤更常表现为肿瘤体积较大(<0.0001)和远处转移(<0.0001)。结肠神经内分泌肿瘤的预后较差(P = 0.027),5年总生存率分别为66.7%和88.1%。神经内分泌瘤(NET)、神经内分泌癌(NEC)和混合性神经内分泌-非神经内分泌肿瘤(MANEC)分别见于61.8%、23.5%和14.7%的患者。多因素分析显示,肿瘤部位不是独立的预后因素(P = 0.081),但肿瘤大小(P = 0.037)和病理分类(P = 0.012)是独立的预后因素。结肠和直肠神经内分泌肿瘤之间存在显著差异。多因素分析表明,肿瘤大小和病理分类与预后相关。肿瘤部位不是独立因素。临床实践中观察到的结肠神经内分泌肿瘤较差的预后可能不仅归因于生物学差异,还归因于因诊断延迟导致的结肠神经内分泌肿瘤较大的肿瘤体积。