The analysis of the diagnosis and treatment of 87 gastroenteropancreatic neuroendocrine neoplasm eases
10.3760/cma.j.issn.0254-1432.2011.08.007
- VernacularTitle:87例胃肠胰神经内分泌肿瘤的诊治分析
- Author:
Yuhong WANG
;
Yuan LIN
;
Ling XUE
;
Jinhui WANG
;
Minhu CHEN
;
Jie CHEN
- Publication Type:Journal Article
- Keywords:
Gastrointestinal neoplasms;
Pancreatic neoplasms;
Neuroendocrine tumors;
Endoscopy;
Neoplasm metastasis;
Prognosis
- From:
Chinese Journal of Digestion
2011;31(8):531-535
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the occurrence site, clinical manifestations, endoscopic and radiographicfeatures, pathologiccharacteristics, diagnosis, treatmentandprognosisof gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN).MethodsFrom January 2000 to June 2010,medical records of 87 GEP-NEN patients in the First Affiliated Hospital of Sun Yat-sen University were collected. The neuroendocrine properties of the tumors were determined by immunohistochemistry staining of neuroendocrine markers Syn and CgA.Then according to histology and proliferation activity, the GEP-NEN tumors were classified as neuroendocrine tumor (G1 and G2 grade), neuroendocrine carcinoma (G3 grade) and mixed adenoendocrine carcinoma (G3 grade).Results36 cases (41.4％) of GEP-NEN tumors were in pancreas, followed by 18 cases in rectum (20.7％), 9 cases in stomach (10.3％) and 6 cases in duodenum (6.9％).Total 69 of 87 GEP-NEN cases (74.7％) were nonfunctional tumors, a variety of gastrointestinal symptoms or symptoms caused by local tumor compression were the most first symptoms, and no one case presented carcinoid syndrome.The manifestations of endoscopy and radiographic image were tumor occupying lesion.Of 87 GEP-NEN cases, 69 cases were neuroendocrine tumor (79.7％), 13 cases were neuroendocrine carcinoma (14.9％) and 5 cases were mixed adenoendocrine carcinoma (5.4％).The percentage of grade G1, G2 and G3 tumors were 64.9％、 14.9％ and 20.2％ respectively.Muscularis or serosa infiltration were found in 22 GEP-NEN patients (47.8％) at the first visit, lymphatic metastasis was in 18 cases (20.7％) and distant metastasis were in 18 cases (20.7％), mostly migrated to liver.Immunohistochemistry staining positive rates of CgA and Syn were 74.2％ and 88.1％.A total of 79 patients (90.8％) were underwent surgery.The 1-, 3-and 5-year survival rates were 76.9％, 54.2％and 41.7％ during follow-up.ConclusionsGEP-NEN may occur at any part of the digestive system,the clinical manifestations are variable.Endoscopy and radiographic examination play an important role in tumor diagnosis, but final diagnosis is mainly based on pathological detection, and surgery is the main treatment option.The prognosis of the tumor is correlated with the pathological classification,grading and condition of distant metastasis.
