Clinical characteristics of 61 cases of colorectal neuroendocrine tumor
10.3760/cma.j.cn311367-20191010-00436
- VernacularTitle:结直肠神经内分泌瘤61例的临床特点分析
- Author:
Bin ZHAO
1
;
Rui LI
;
Hongqing QIU
Author Information
1. 苏州大学附属张家港医院消化内科 215600
- From:
Chinese Journal of Digestion
2020;40(5):314-319
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics of colorectal neuroendocrine tumor (NET) and to improve the clinical knowledge of this disease.Methods:From January 2011 to December 2018, the clinical data of 61 cases of pathologically diagnosed colorectal NET in Zhangjiagang Hospital Affiliated to Soochow University (19 cases) and The First Affiliated Hospital of Soochow University (42 cases) were collected. The general information, location, clinical manifestations, histological characteristics and pathological grading, immunohistochemical staining, treatment, follow-up and prognosis of the patients were retrospectively analyzed. Chi square test was used for statistical analysis.Results:All the 61 patients with colorectal NET had single lesion, including 36 males (59.0%) and 25 females (41.0%); the age was (56.3±9.2) years. The NET 55 cases (90.2%) located in rectum and six cases (9.8%) in colon. In terms of the main clinical manifestations, 61 cases of colorectal NET had no obvious clinical manifestations or had abdominal discomfort, accounted for 54.1% (33/61) and 16.4% (10/61) respectively. Among 55 patients with rectal NET, 31 patients had no obvious clinical manifestations, and seven patients had abdominal discomfort.Among six patients with colon NET, three patients had abdominal discomfort, and two patients had no obvious clinical manifestations. Among 61 patients with colorectal NET, the maximum tumor diameter was (0.95±1.28) cm, 86.9% (53/61) of them had a maximum tumor diameter ≤2.0 cm, and the pathological grade was mainly G1-NET (93.4%, 57/61). Rectal NET appeared as polypoid or submucosal protrusion, while colon NET showed with ulcer on the surface. Forty-nine cases of colorectal NET received immunohistochemical staining, and the positive rates of synaptophysin, chromogranin A and Ki-67 were 89.8% (44/49), 75.5% (37/49) and 81.6% (40/49), respectively. Fifty-two cases underwent endoscopic treatment, among them 45 cases received endoscopic mucosal resection (EMR) and seven cases received endoscopic submucosal dissection(ESD). Postoperation pathology indicated that specimen resection margin of 17 cases were positive. The positive rate of patients with EMR was 35.6% (16/45), which was higher than that of patients with ESD (one of seven patients with ESD), and the difference was statistically significant ( χ2=3.471, P< 0.05). The follow-up was completed in 54 patients, only one rectal NET patient had local recurrence. Conclusions:Among the patients with colorectal NET enrolled in this study, the proportion of male patients is higher than that of female patients. The lesions are more common in the rectum, and most of them have no obvious clinical symptoms. Polypoid protuberance or ulcer are more often seen under endoscopy. The diagnosis mainly depends on pathological and immunohistochemical results, and the positive rate of ESD margin is lower than that of EMR.
