胃肠道神经内分泌肿瘤的临床病理特征及治疗分析

目的分析胃肠道神经内分泌肿瘤(NEN)的临床病理特点及治疗方法的选择。方法回顾性分析32例胃肠道NEN的临床及病理资料。结果肿瘤发病以直肠最多见,胃次之。临床表现以腹痛、腹胀为主。组织学分型与肿瘤淋巴结转移有相关性,G3型患者更易发生淋巴结转移。组织学分型与肿瘤大小、浸润深度无明显相关性。22例行手术治疗,10例行内镜下黏膜剥离术。术后成功随访29例,中位存活期为53个月。29例患者的1、3、5年生存率分别为90.3%、78.5%和55.1%。结论胃肠道NEN直肠多发,其临床表现多样;不同组织学分型的肿瘤淋巴结转移与预后不同;手术切除及内镜下黏膜剥脱术是常用的两种治疗方法,具体选择应依据肿瘤的生物学特性。

Analysis on Clinicopathologic Features and Treatment of Gastrointestinal Neuroendocrine Neoplasm

Objective To investigate the pathologic features and treatment of gastrointestinal neuroendocrine neoplasm(NEN).Methods The clinical literatures of 32 patients with gastrointestinal NEN were analyzed retrospectively.Results Gastrointestinal NEN mainly occurred in rectum in our group,then in stomach.The main clinical presentations were abdominal pain and distension.Histological type was correlated with the lymph node metastasis.Patients with G3 stage were more likely to have lymph node metastasis.There was no significant correlation between the histological type,tumor size and invasion.22 patients underwent surgical treatment,and 10 patients received endoscopic submucosal dissection.29 patients were followed up successfully.Median survival was 53 months.The survival rate of 1,3,5 year was respectively 90.3%,78.5% and 50.1%.Conclusion Gastrointestinal NEN mainly occurred in rectum,and the clinical presentations are nonspecific.The rate of lymph node metastasis and prognosis is variant in different histological types.Surgery and endoscopic therapy are the most common treatments.The appropriate treatment should be selected according to NEN biological characteristics.