1.Clinical and pathologic characteristics of 50 patients with gastric neuroendocrine neoplasms
Wenwen HOU ; Tongyu TANG ; Jing WANG ; Tantan MA ; Tingting CAO ; Fudong LI ; Hong XU
Chinese Journal of Digestive Endoscopy 2017;34(7):502-505
Objective To investigate the clinical and pathologic features of patients with gastric neuroendocrine neoplasms (g-NENs).Methods A total of 50 cases of g-NENs diagnosed by pathology in the First Hospital of Jilin University from May 2012 to January 2016 were retrospective analyzed to summarize the clinical manifestations and pathological features.The location of lesion,gross morphology,maximum diameter,lymph node metastasis rate,distant metastasis rate,and survival time between patients with neuroendocrine tumors and neuroendocrine carcinomas were compared.Results Among the 50 patients,34 were males and 16 were females with a male to female ratio of 2.125 ∶ 1.Their age ranged from 33 to 77 years with an mean age of 60± 11 years.There were 13 cases (26%) of neuroendocrine tumors,31 (62%) neuroendocrine carcinomas,and 6 (12%) mixed adenoneuroendocrine carcinomas.The maximum diameter of lesion was less than 2 cm in 8 cases (16%),and equal or greater than 2 cm in 42 cases (84%).There was single lesion in 48 cases (96%) and multiple lesions in 2 cases (4%).There were 19 cases (38%) located in gastric antrum,16 (32%) in gastric body,11 (22%) in gastric fundus or cardia,3 (6%) in gastric angle,and 1 (2%) in the junction of gastric antrum and body.Thirty-two patients (64%) had metastasis,including 20 cases of lymph node metastasis and 12 cases of distant metastasis.The clinical symptoms of the patients were different,mainly were digestive system symptoms and tumor occupying symptoms,and no carcinoid syndrome was reported.The gross morphology (x2 =24.446.P =0.000).maximum diameter (t =-4.044,P =0.001),lymph node metastasis rate (x2=4.435,P =0.035),and survival time (t =2.925,P =0.000) were significantly differences between 13 cases of neuroendocrine tumors and 37 cases of neuroendocrine carcinoma.But the location of lesion (x2 =6.921,P=0.082) and distant metastasis rate (x2 =0.715,P =0.389) were no statistically different between the two groups.Conclusion Gastric neuroendocrine neoplasms can occur in any part of stomach,majority of tumor is single lesion and lack of specific clinical manifestations.The mostly gross morphology of gastric neuroendocrine carcinoma and mixed adenoneuro-endocrine carcinoma are ulcer type with a large diameter and poor prognosis.