Analysis of clinical and endoscopic features of elderly patients with early gastric neuroendocrine tumors
10.3760/cma.j.issn.0254-9026.2025.11.007
- VernacularTitle:老年人早期胃神经内分泌肿瘤的临床及内镜特征分析
- Author:
Xue SUN
1
;
Yuchen ZHOU
;
Yan ZHANG
;
Jun DU
;
Ziyu WANG
;
Yan ZHOU
;
Qingfeng LUO
;
Li ZHAO
Author Information
1. 北京医院全科医学科 国家老年医学中心 中国医学科学院老年医学研究院，北京 100730
- Publication Type:Journal Article
- Keywords:
Gastric neuroendocrine neoplasm;
Magnifying gastroscopy;
Endoscopic submucosal dissection
- From:
Chinese Journal of Geriatrics
2025;44(11):1514-1521
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical and endoscopic features of elderly patients with early gastric neuroendocrine neoplasms(g-NEN)to provide insights for clinical diagnosis and treatment.Methods:Seven cases of early-stage g-NEN in elderly patients admitted to Beijing Hospital from May 2020 to October 2024 were reported.Information including patient demographics, medical history, laboratory findings, endoscopic features, and pathological results was summarized an analyzed.Meanwhile, a literature review was conducted on g-NEN cases reported domestically and internationally from the establishment of databases to April 2025, with a comparative analysis of baseline characteristics, background mucosal conditions, and pathological diagnoses.Results:A total of 7 elderly patients with early g-NEN were included, including 3 males and 4 females, with an average age of 67 years at diagnosis.Endoscopic and pathological features: endoscopic lesions were mainly located on the greater curvature of the stomach, mostly slightly elevated, with 4/7(57.1%)being single lesions and the others accompanied by multiple polyps.The size of gastric neuroendocrine tumor(g-NET) lesions ranged from 1 mm to 19 mm, with a median Kyoto gastritis score of 3.In terms of pathological grading, there were 6 cases of G1 and 1 case of gastric neuroendocrine carcinoma(g-NEC). All 7 patients underwent endoscopic submucosal dissection(ESD). The follow-up period after surgery ranged from 3 months to 4 years, and no tumor was found at the vertical and horizontal margins of all lesions on pathology.A literature review of 32 reported cases showed that 40.6%(13/32)of cases exhibited background mucosal atrophy or intestinal metaplasia, with positive rates of chromogranin A(CgA) and synapsin(Syn)reaching 95.8%(23/24) and 100.0%(25/25), respectively.Notably, elderly patients with g-NEC demonstrated aggressive invasiveness, with a metastasis rate of 62.5%(5/8).Conclusions:Elderly patients with g-NEN exhibit high heterogeneity and significant differences in invasiveness, necessitating heightened clinical vigilance.Precise management should integrate background mucosal status, Kyoto gastritis score, pathological biomarkers, and imaging techniques.Blue laser imaging with magnifying endoscopy(BLI-ME)and endoscopic ultrasonography(EUS)can further analyze the characteristics of these tumors, and endoscopic submucosal dissection(ESD)remains the primary treatment modality for early-stage g-NEN.
