Yin Xiao-Nan, Shen Chao-Yong, Yin Yi-Qiong, Chen Hui-Jiao, Chen Hai-Ning, Yin Yuan, Han Lu-Yin, Chen Jia-Ju, Tang Su-Min, Chen Zhi-Xin, Zhang Bo
Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Asia Pac J Clin Oncol. 2018 Apr;14(2):e37-e44. doi: 10.1111/ajco.12760. Epub 2017 Aug 30.
The aim of this study is to investigate the clinicopathological characteristics, as well as explore the prognostic accuracy of the proposed new classification in gastrointestinal NENs (GI-NENs) patients.
Patients diagnosed with GI-NENs were retrospectively indentified from existing databases of the pathological institute at our institution from January 2009 to November 2015.
We identified 414 patients with GI-NENs, 250 cases were diagnosed as neuroendocrine tumor G1 (NET G1), 25 as neuroendocrine tumor G2 (NET G2), 53 as neuroendocrine tumor G3 (NET G3), 55 as neuroendocrine carcinoma G3 (NEC G3), and 31 as mixed adenoneuroendocrine carcinoma (MANEC); the overall survival (OS) rate at three years were 94.9%, 91.7%, 74.3%, 62.7% and 38.1%, respectively. The difference in progression-free survival (PFS) duration among the patients with NET G1, NET G2, NET G3, NEC G3, and MANEC was statistically significant (P < 0.001). However, the PFS of NEC G3 and MANEC was low and similar (P = 0.090). In multivariate analysis of patients with GI-NENs, surgical margin, comorbidity, proposed new classification and tumor location were useful predictors of OS (P < 0.05).
Our findings suggest that the proposed new classification can accurately reflect the clinical outcome, together with surgical margin, comorbidity, and tumor location may be meaningful prognostic factors for the OS of GI-NENs.
本研究旨在调查胃肠道神经内分泌肿瘤（GI-NENs）患者的临床病理特征，并探讨所提出的新分类方法的预后准确性。
从2009年1月至2015年11月我院病理研究所现有数据库中回顾性识别诊断为GI-NENs的患者。
我们共识别出414例GI-NENs患者，其中250例被诊断为神经内分泌肿瘤G1（NET G1），25例为神经内分泌肿瘤G2（NET G2），53例为神经内分泌肿瘤G3（NET G3），55例为神经内分泌癌G3（NEC G3），31例为混合性腺神经内分泌癌（MANEC）；三年总生存率（OS）分别为94.9%、91.7%、74.3%、62.7%和38.1%。NET G1、NET G2、NET G3、NEC G3和MANEC患者的无进展生存期（PFS）差异具有统计学意义（P < 0.001）。然而，NEC G3和MANEC的PFS较低且相似（P = 0.090）。在GI-NENs患者的多因素分析中，手术切缘、合并症、所提出的新分类和肿瘤位置是OS的有用预测因素（P < 0.05）。
我们的研究结果表明，所提出的新分类方法能够准确反映临床结局，连同手术切缘、合并症和肿瘤位置可能是GI-NENs患者OS的有意义的预后因素。
