Analysis of 39 cases of gastrointestinal neuroendocrine neoplasms and evaluation of the efficacy of endoscopic submucosal dissection
10.3969/j.issn.1000-8179.2018.12.054
- VernacularTitle:39例胃肠神经内分泌肿瘤经内镜黏膜下剥离术的治疗效果评价
- Author:
Bianxia LI
1
;
Xin CHEN
;
Zhongqing ZHENG
;
Tao WANG
;
Yujie ZHANG
;
Shu LI
;
Lanping ZHU
;
Shuang MA
;
Bangmao WANG
Author Information
1. 天津医科大学总医院消化科 天津市300052
- Keywords:
gastrointestinal neuroendocrine neoplasms (GI-NENs);
endoscopic submucosal dissection (ESD);
indications;
prognosis
- From:
Chinese Journal of Clinical Oncology
2018;45(12):623-627
- CountryChina
- Language:Chinese
-
Abstract:
To investigate the safety and clinical efficacy of endoscopic submucosal dissection (ESD) in the treatment of gastrointestinal neuroendocrine neoplasms (GI-NENs). Methods: The clinical and pathological features of 39 patients with GI-NENs who were treated with ESD, the efficacy of ESD treatment, complications, and follow-up results were analyzed retrospectively. Results: The 39 cases of GI-NENs were all neuroendocrine tumors (NETs). According to histopathology and proliferative activity, there were 37 cases of G1, two cases of G2, and no cases of G3, including 23 cases of cancer in the rectum, 12 in the stomach, 4 in the duodenum. Thirty-five lesions invaded the mucosa or submucosa, four invaded the muscularis propria, one perforated in the ESD, and two were associated with bleeding. After 6 to 90 months of follow-up, new lesions were found in 1 patient with g-NETs in different parts of the stomach at 5 and 34 months after operation, followed by ESD treatment and further follow-up. No lymph node and distant metastases were found, and the survival rate of the patients was 100%. Conclusions: For GI-NENs without lymph node and distant metastases, the lesion is con-fined to the submucosa, and a diameter≤1.0 cm is an absolute indication of ESD. For rectal neuroendocrine neoplasms that have non-invasive muscularis propria with diameters between 1 and 1.5 cm, or for patients with Type 1 gastric neuroendocrine tumors (T1-GNETs) that are predicted to be T2, ESD treatment should be prioritized to preserve gastrointestinal volume and function.
