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一项11年的回顾性研究:胃肠胰神经内分泌肿瘤的临床病理及生存分析

An 11-year retrospective study: clinicopathological and survival analysis of gastro-entero-pancreatic neuroendocrine neoplasm.

作者信息

Liu Hua, Xie Rongli, Zhao Zhifeng, Xu Dan, Yang Kaige, Ding Min, Tan Dan, Liao Wenqiang, Han Xujie, Zhang Jun, Shen Dongjie, Yuan Jianmin, Xu Zhiwei, Fei Jian

机构信息

Department of General Surgery, Ruijin Hospital/Lu Wan Branch, Shanghai Jiao Tong University, School of Medicine.

Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine.

出版信息

Medicine (Baltimore). 2020 Aug 14;99(33):e21682. doi: 10.1097/MD.0000000000021682.

Abstract

To investigate the clinicopathological characteristics and relevant prognostic factors of gastro-entero-pancreatic neuroendocrine neoplasm (GEP-NEN), to improve our understanding of GEP-NEN.This was a retrospective analysis of 155 patients (average age 53.7 ± 13.6 years) pathologically diagnosed with GEP-NEN. We analyzed the clinicopathological characteristics, treatment, and prognostic factors of GEP-NEN.The most common primary site was the pancreas (41.9%), followed by the rectum, stomach and duodenum. Most cases were nonfunctional GEP-NENs (149/155) with nonspecific symptoms. TNM stage and histological grade were determined by the latest criteria. Surgical resection was the mainstay of treatment in 150 patients, and 22 patients received chemotherapy under different circumstances. A total of 130 patients were followed up for a median of 44 months, and 1-year and 3-year survival rates were 82.3% and 72.3%, respectively. According to univariate and multivariate analysis, incidental diagnosis, maximum tumor diameter, tumor stage, lymph node and distant metastasis, TNM stage, and histological grade were significantly correlated with overall survival, but histological grade was the only factor confirmed as an independent prognostic factor for long-term survival of GEP-NEN.GEP-NEN, with an increasing trend in incidence, occurred most frequently in the pancreas. Nonfunctional tumors with nonspecific symptoms comprised the majority of cases. The main treatment was surgical resection. Histological grade was confirmed as the only independent prognostic factor.

摘要

为探讨胃肠胰神经内分泌肿瘤(GEP-NEN)的临床病理特征及相关预后因素,以增进我们对GEP-NEN的认识。这是一项对155例经病理诊断为GEP-NEN患者(平均年龄53.7±13.6岁)的回顾性分析。我们分析了GEP-NEN的临床病理特征、治疗及预后因素。最常见的原发部位是胰腺(41.9%),其次是直肠、胃和十二指肠。大多数病例为无功能性GEP-NEN(149/155),症状不具特异性。TNM分期和组织学分级依据最新标准确定。150例患者的主要治疗方式为手术切除,22例患者在不同情况下接受了化疗。共130例患者接受随访,中位随访时间为44个月,1年和3年生存率分别为82.3%和72.3%。根据单因素和多因素分析,偶然诊断、肿瘤最大直径、肿瘤分期、淋巴结及远处转移、TNM分期和组织学分级与总生存显著相关,但组织学分级是唯一被确认为GEP-NEN长期生存独立预后因素的指标。GEP-NEN发病率呈上升趋势,最常发生于胰腺。大多数病例为有非特异性症状的无功能性肿瘤。主要治疗方式为手术切除。组织学分级被确认为唯一的独立预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57ac/7437823/cf5572f785d0/medi-99-e21682-g002.jpg

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