Yamaguchi Tatsuro, Takahashi Keiichi, Yamada Kazutaka, Bando Hiroyuki, Baba Hideo, Ito Masaaki, Funahashi Kimihiko, Ueno Hideki, Fujita Shin, Hasegawa Seiji, Sakai Yoshiharu, Sugihara Kenichi
Department of Surgery Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Tokyo Japan.
Department of Surgery Coloproctology Center Takano Hospital Kumamoto Japan.
Ann Gastroenterol Surg. 2020 Nov 17;5(2):215-220. doi: 10.1002/ags3.12403. eCollection 2021 Mar.
Neuroendocrine tumors (NETs) are one of the subtypes of neuroendocrine neoplasms and are defined as epithelial neoplasms with predominant neuroendocrine differentiation. The aim of this study was to clarify the clinicopathological characteristics of colorectal NETs through a nationwide retrospective study in Japan.
This multicenter retrospective cohort study of NETs in Japan was conducted by the study group of the Japanese Society for Cancer of the Colon and Rectum. In this study, we aimed to clarify the characteristics of Japanese patients with colorectal NETs. This cohort study included patients with colorectal NETs who were treated from January 2011 to December 2015.
Most NETs developed in the lower rectum. Predictive factors of lymph node metastasis included size (>10 mm), depth of invasion (muscular propria or greater), NET grade (NET G2), depressed lesion of the tumor, and lymphovascular infiltration. In particular, depressed lesion of the tumor and lymphovascular infiltration were independent predictive factors of lymph node metastasis. The presence of an increased number of these predictive factors increased the lymph node metastasis rate.
Surgical resection with lymph node dissection is considered in the colorectal NETs patients with predictive factors of lymph node metastasis, the number of which is correlated with incidence of lymph node metastasis.
神经内分泌肿瘤（NETs）是神经内分泌肿瘤的亚型之一，被定义为具有主要神经内分泌分化的上皮性肿瘤。本研究的目的是通过在日本全国范围内进行的回顾性研究，阐明结直肠NETs的临床病理特征。
日本结直肠癌学会研究组开展了这项关于日本NETs的多中心回顾性队列研究。在本研究中，我们旨在阐明日本结直肠NETs患者的特征。该队列研究纳入了2011年1月至2015年12月期间接受治疗的结直肠NETs患者。
大多数NETs发生在直肠下段。淋巴结转移的预测因素包括大小（>10毫米）、浸润深度（固有肌层或更深）、NET分级（NET G2）、肿瘤凹陷性病变和淋巴管浸润。特别是，肿瘤凹陷性病变和淋巴管浸润是淋巴结转移的独立预测因素。这些预测因素数量的增加会提高淋巴结转移率。
对于具有淋巴结转移预测因素的结直肠NETs患者，考虑进行手术切除并清扫淋巴结，预测因素的数量与淋巴结转移发生率相关。
