Li Yuan-Liang, Qiu Xu-Dong, Chen Jie, Zhang Yu, Li Jie, Xu Jian-Ming, Wang Chao, Qi Zhi-Rong, Luo Jie, Tan Huang-Ying
Beijing University of Chinese Medicine, Beijing 100029, China.
Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China.
World J Gastrointest Oncol. 2020 Dec 15;12(12):1416-1427. doi: 10.4251/wjgo.v12.i12.1416.
For the rarity of type 3 gastric neuroendocrine tumours (g-NETs), their clinicopathological characteristics and prognosis are not well illustrated.
To describe the clinicopathological features and outcome of type 3 g-NETs in the Chinese population.
Based on the 2019 WHO pathological classification, the clinicopathological characteristics and prognosis of patients with type 3 g-NETs in China were retrospectively analysed.
A total of 77 patients (55.8% of females) with type 3 g-NETs were analysed, with a median age of 48 years (range: 28-79 years). The tumours were mainly located in the gastric fundus/body (83.1%) and were mostly solitary (83.1%), with a median size of 1.5 cm (0.8-3.5 cm). Of these, there were 37 G1 tumours (48.1%), 31 G2 (40.3%), and 9 G3 (11.7%). Ten (13.0%) and 24 (31.2%) patients had lymph node and distant metastasis, respectively. In addition, type 3 g-NETs were heterogeneous. Compared with G1 NETs, G2 NETs had a higher lymph node metastasis rate, and G3 NETs had a higher distant metastasis rate. G1 and G2 NETs with stage I/II disease (33/68) received endoscopic treatment, and no tumour recurrence or tumour-related death was observed within a median follow-up time of 36 mo. Grade and distant metastasis were identified to be independent risk factors for prognosis in multivariable analysis.
Type 3 g-NETs are obviously heterogeneous, and the updated WHO 2019 pathological classification may be used to effectively evaluate their biological behaviors and prognosis. Also, endoscopic treatment should be considered for small (< 2 cm), low grade, superficial tumours.
由于3型胃神经内分泌肿瘤(g-NETs)较为罕见,其临床病理特征及预后尚未得到充分阐明。
描述中国人群中3型g-NETs的临床病理特征及转归。
基于2019年世界卫生组织病理分类,对中国3型g-NETs患者的临床病理特征及预后进行回顾性分析。
共分析了77例3型g-NETs患者(女性占55.8%),中位年龄为48岁(范围:28 - 79岁)。肿瘤主要位于胃底/胃体(83.1%),多为单发(83.1%),中位大小为1.5 cm(0.8 - 3.5 cm)。其中,G1级肿瘤37例(48.1%),G2级31例(40.3%),G3级9例(11.7%)。分别有10例(13.0%)和24例(31.2%)患者发生淋巴结转移和远处转移。此外,3型g-NETs具有异质性。与G1级NETs相比,G2级NETs的淋巴结转移率更高,G3级NETs的远处转移率更高。I/II期G1和G2级NETs患者(33/68)接受了内镜治疗,中位随访36个月期间未观察到肿瘤复发或肿瘤相关死亡。多变量分析确定分级和远处转移是预后的独立危险因素。
3型g-NETs具有明显的异质性,2019年更新的世界卫生组织病理分类可有效评估其生物学行为和预后。此外,对于小(< 2 cm)、低分级、表浅的肿瘤应考虑内镜治疗。