222例神经内分泌肿瘤诊治及随访分析

目的探讨全身神经内分泌肿瘤(NET)的好发部位、临床症状、影像学及预后。方法回顾性分析南方医院2001年1月至2012年4月222例NET患者的病历资料。结果 222例NET患者中,152例(68.5%)NET发生在消化道。突触素(Syn)、嗜铬素A(CgA)、神经元特异性烯醇化酶(NSE)免疫组织化阳性率分别为85.1%、64.2%、81.9%。首诊淋巴结转移率为23.9%,随访结束时远处转移率为30.6%;淋巴转移和远处器官转移随肿瘤直径增加而升高。193例接受手术治疗(108例内镜下治疗),1年、3年、5年总生存率分别为86.1%、73.0%和70.9%。年龄50岁发生转移者生存时间明显缩短。结论 NET可发生于全身许多器官和组织,以消化道最为多见,肿瘤直径与转移密切相关,患者年龄及肿瘤转移与预后有关。

Diagnosis,treatment, and follow-up of 222 patients with neuroendocrine tumor

Objective The aim of this study was to explore the occurrence site, clinical manifestations, imaging characteristics, and prognosis of neuroendocrine tumor （NET）. Methods From Jan. 2001 to Apr. 2012, medical records of 222 NET patients which were confirmed by pathology in Nanfang Hospital were ana-lyzed retrospectively. Results Of the 222 NET cases, 152 cases （68.5%） of NET were located in gastrointesti-nal tract. The positive rates of synaptophysin （Syn）, chromogranin A （CgA）, and neuron specific enolase （NSE） were 85.1%, 64.2%, and 81.9%, respectively. Lymphatic metastases were found in 53 cases （23.9%） at the first visit, and distant metastases in 68 cases （30.6%） at last follow-up. The lymph node metastasis and distant metastasis elevated with the increasing tumor diameter. Surgery, including 108 cases of endoscopic treatment, was performed in 193 cases. The 1-, 3-, 5-year total survival rates were 86.1%, 73.0%, 70.9%, respectively. Age＆gt;50 years, lymphatic and distant metastasis contributed to unfavorable prognosis, while gender had no ef-fect on overall survival. Conclusion NET may occur at many organs and tissues, but most of the NET occurs in the gastrointestinal tract. Endoscopy and imaging examination play an important role in diagnosis, but final diagnosis is mainly based on pathological diagnosis. Surgery is the major treatment option. The diameter of NET is closely related to metastasis. The prognosis of NET is correlated with age and metastasis.