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胃神经内分泌肿瘤(G-Nets):发病率、预后及生存改善的近期趋势

Gastric Neuroendocrine Tumors (G-Nets): Incidence, Prognosis and Recent Trend Toward Improved Survival.

作者信息

Yang Zhen, Wang WeiHua, Lu JingFeng, Pan Gaofeng, Pan Zhiyu, Chen Qian, Liu Weiyan, Zhao Yanping

机构信息

Department of General surgery, Minhang Hospital, Fudan University, Minhang, China.

Department of Thoracic surgery, Minhang Hospital, Fudan University, Minhang, China.

出版信息

Cell Physiol Biochem. 2018;45(1):389-396. doi: 10.1159/000486915. Epub 2018 Jan 22.

Abstract

BACKGROUND/AIMS: Gastric neuroendocrine tumors (G-NETs) are uncommon neoplasms that can present with or without clinical symptoms. In this study, we evaluated the incidence, prognosis, and temporal trends of G-NETs.

METHODS

We analyzed all cases of G-NETs registered in the Surveillance, Epidemiology, and End Results (SEER) database from 1973 to 2014. Incidence was estimated by age and joinpoint analyses. Survival rates were calculated and survival trends over time were evaluated.

RESULTS

A total of 3740 eligible patients were enrolled in the study. G-NETs incidence increased from 0.31 per 1 000 000 patients in 1975 to 4.85 in 2014, with an annual percentage changes (APCs) of 8.9% (95% confidence interval [CI] = 7.7% to 10.21%, P < 0.001, t test (29) from 1975 to 2001 and 3.6% from 2002 to 2014 (95% CI= 2.3% to 4.9%, P < 0.001). For cases diagnosed between 1973 and 1982, five-year survival was 62.8% ± 7.0% (Standard error, SE) and increased to 86.7% ± 0.7% for cases diagnosed between 2003 and 2012 (P < 0.001). Years of diagnosis, gender, age at diagnosis, marital status, grade, tumor size, tumor stage, and surgery performed or not were the strongest predictors of worse survival in both univariate and multivariate analysis (P<0.05).

CONCLUSION

G-NETs are uncommon neoplasms but the incidence is growing. Survival has improved in the past decades. Years of diagnosis, gender, age at diagnosis, marital status, grade, tumor size, tumor stage, and surgery status predict survival in patients with G-NETs.

摘要

背景/目的:胃神经内分泌肿瘤(G-NETs)是一种罕见的肿瘤,可伴有或不伴有临床症状。在本研究中,我们评估了G-NETs的发病率、预后及时间趋势。

方法

我们分析了1973年至2014年监测、流行病学和最终结果(SEER)数据库中登记的所有G-NETs病例。通过年龄和连接点分析估计发病率。计算生存率并评估随时间的生存趋势。

结果

本研究共纳入3740例符合条件的患者。G-NETs的发病率从1975年的每100万患者0.31例增加到2014年的4.85例,1975年至2001年的年百分比变化(APC)为8.9%(95%置信区间[CI]=7.7%至10.21%,P<0.001,t检验(29)),2002年至2014年为3.6%(95%CI=2.3%至4.9%,P<0.001)。对于1973年至1982年诊断的病例,五年生存率为62.8%±7.0%(标准误,SE),而2003年至2012年诊断的病例则增至86.7%±0.7%(P<0.001)。在单因素和多因素分析中,诊断年份、性别、诊断时年龄、婚姻状况、分级、肿瘤大小、肿瘤分期以及是否进行手术是生存预后较差的最强预测因素(P<0.05)。

结论

G-NETs是罕见肿瘤,但发病率正在上升。在过去几十年中,生存率有所提高。诊断年份、性别、诊断时年龄、婚姻状况、分级、肿瘤大小、肿瘤分期和手术状态可预测G-NETs患者的生存情况。

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