Division of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China.
Institute of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Dis Markers. 2018 Oct 17;2018:9191639. doi: 10.1155/2018/9191639. eCollection 2018.
The objective of this study was to analyze the clinical features and prognosis of gastroenteropancreatic (GEP) neuroendocrine carcinomas (NECs) with liver metastasis and primary hepatic neuroendocrine carcinomas (PHNECs), as these rare hepatic neuroendocrine carcinomas have not been exhaustively studied.
The clinical data of 47 patients with hepatic NECs were retrospectively reviewed and categorized to analyze features and prognosis.
The 47 studied cases comprised 13 cases of primary hepatic NECs (primary group) and 34 cases of metastatic hepatic NECs (metastatic group). Male patients were slightly dominant in both groups, while no age predilection was present. PHNECs were mostly single nodules located in the right lobe of the liver. Metastatic hepatic NECs originated mostly from the pancreas and stomach without distinction of the lobes of the liver. Univariate analysis showed that the treatment protocol (radical operation or others) was correlated with the overall survival (OS; < 0.05) in the primary group, while treatment protocol and cytokeratin 7 (CK7) were associated with OS ( < 0.05) in the metastatic group. Cox proportional hazard regression showed that radical operation was an independent prognostic factor ( < 0.05) for OS in the metastatic group.
No significant differences in the clinicopathological features between PHNECs and metastatic hepatic GEP NECs were found, but radical operation was significantly correlated with OS for both carcinomas. Radical operation is the first choice for patients who are eligible for operation.
本研究旨在分析伴肝转移的胃肠胰神经内分泌癌（GEP-NEC）和原发性肝神经内分泌癌（PHNEC）的临床特征和预后，因为这些罕见的肝神经内分泌癌尚未得到充分研究。
回顾性分析了 47 例肝 NEC 患者的临床资料，并进行了分类分析。
47 例研究病例包括 13 例原发性肝 NEC（原发性组）和 34 例转移性肝 NEC（转移性组）。两组均以男性略占优势，且无年龄偏好。PHNEC 多为单发结节，位于肝右叶。转移性肝 NEC 多来源于胰腺和胃，无肝叶分布差异。单因素分析显示，在原发性组中，治疗方案（根治性手术或其他）与总生存期（OS；<0.05）相关，而在转移性组中，治疗方案和细胞角蛋白 7（CK7）与 OS 相关（<0.05）。Cox 比例风险回归显示，根治性手术是转移性组 OS 的独立预后因素（<0.05）。
PHNEC 和转移性 GEP-NEC 的临床病理特征无明显差异，但根治性手术与两种肿瘤的 OS 显著相关。对于符合手术条件的患者，根治性手术是首选。
