胃神经内分泌肿瘤预后相关因素的临床分析（附71例）

目的:分析71例胃神经内分泌肿瘤（G-NEN）的临床特征及预后相关因素。方法:回顾性分析2009年7月至2018年10月西京医院收治的71例G-NEN患者的临床病理资料及随访资料，分析其临床病理学特征及预后相关因素。结果:单因素生存分析结果显示:5年生存率与年龄、肿瘤分级、TNM分期、肿瘤转移方面差异具有统计学意义（P<0.05）；3年生存率与肿瘤分级、TNM分期、肿瘤转移方面差异具有统计学意义（P<0.05）；1年生存率与TNM分期、肿瘤转移方面差异具有统计学意义（P<0.05）。多因素 Cox风险生存模型统计结果表明TNM分期和复发转移是影响胃神经内分泌癌预后的独立因素（P<0.05），性别、年龄、肿瘤直径、肿瘤分类、肿瘤分级、化疗与否、手术方式等与其预后无关（P>0.05）。复发转移在性别、年龄、肿瘤直径、肿瘤分级、肿瘤分类、脉管/神经侵犯、淋巴结转移数目、淋巴结转移、手术方式、辅助化疗上均不存在显著差异（P>0.05）；是否复发转移在TNM分期上存在显著差异（P<0.05）。结论:年龄、肿瘤分级、肿瘤分期、是否复发转移是影响胃神经内分泌癌患者术后生存时间的因素，肿瘤分期、是否复发转移是影响患者预后的独立危险因素。

Clinical evaluation of prognostic factors for gastric neuroendocrine tumors（71 cases）

Objective:To evaluate the characteristics，diagnosis，treatment and prognosis of 71 cases of gastric neuroendocrine tumors to improve our knowledge of gastric neuroendocrine tumors，provide more reliable evidence for clinical diagnosis and treatment，reduce misdiagnosis rate and improve the level of diagnosis and treatment of gastric neuroendocrine tumors.Methods:A retrospective analysis was made of 71 patients with gastric neuroendocrine tumors diagnosed in our hospital from July 2009 to October 2018.The relationship between age，gender，pathological type，pathological grade，lymphatic metastasis，distant metastasis，TNM stage，surgical treatment，chemotherapy and 1-year survival rate，3-year survival rate and 5-year survival rate was analyzed.Kaplan-Meier method was used for univariate survival analysis.Log-rank test was used for survival comparison，and Cox regression was used for multivariate survival analysis to explore independent risk factors affecting the prognosis of gastric neuroendocrine tumors.The P value of <0.05 was statistically significant.Results:Univariate survival analysis showed that there were significant differences in 5-year survival rate with age，tumor grade，TNM stage and tumor metastasis(P<0.05)，3-year survival rate with tumor grade，TNM stage and tumor metastasis(P<0.05)，and 1-year survival rate with TNM stage and tumor metastasis(P<0.05).Multivariate Cox risk survival model showed that TNM stage and recurrence and metastasis were endependent factors affecting the prognosis of gastric neuroendocrine carcinoma(P<0.05).Gender，age，tumor diameter，tumor classification，tumor grade，chemotherapy or not，and surgical procedure were not related to the prognosis(P>0.05).There were no significant differences in gender，age，tumor diameter，tumor grade，tumor classification，vessel/nerve invasion，number of lymph node metastasis，lymph node metastasis，operation method and adjuvant chemotherapy(P>0.05)，and there were significant differences in TNM staging in recurrence and metastasis(P<0.05).Conclusion:Age，tumor grade，tumor stage，recurrence and metastasis were the factors affecting the survival time of patients with gastric neuroendocrine carcinoma.Tumor stage，recurrence and metastasis were independent risk factors affecting the prognosis of patients.