| ObjectiveBased on the clinical pathologic data and follow-up results of patients with gastrointestinal neuroendocrine neoplasms were analyzed, to explore the clinical pathologic characteristics and prognosis of gastrointestinal neuroendocrine neoplasm.MethodSelection of cases in Shandong Provincial Hospital from September2010to March2014,which all were confirmed by pathological diagnosis for patients with GI-NENs, a total of41cases. Adopt the method of retrospective analysis and follow-up, with statistics of onset age, sex, tumor location, clinical manifestations, preoperative auxiliary examination, treatment and postoperative pathological results, and follow-up of patients with postoperative survival situation and the drug-use information, then based on the statistical analysis of such data, the conclusions are obtained.Results1. This study includes statistics of113patients. Of all the patients,5cases in9-12,2010;2011,25patients;37cases in2012;2013,37cases;9cases in the first quarter of2014.the number of male and female are81and32, the rate is2.53:1.The onset age is26-81,the mean age is55.4, the median age is55.5.2. Of all the113cases,65(57.5%) are in the stomach, while33(29.2%) in rectum,10(8.9%) in small intestine,4(3.5%) in colon,1(0.9%) in ileocecal junction. About the maximum diameter of tumor focus,12(%) are<1cm,12(%) are in2-4cm,12(%) are>4cm. 3. Of all the103cases with clinical symptom information, non-functional symptom accounts for96.12%(99/103),while functional symptom accounts only for3.88%(4/103)4. In preoperative period,to reveal lesion is mainly by endoscopic examination,the lesion detection rate is98.1%(106/108).The lesion detection rate of other accessory examination as CT、MRI、EUS is respectively87.1%(54/62)、100%(1/1).100%(9/9).5. A total of94cases with tumor size information, according to which was divided into<1cm,1-2cm,>2cm groups, in each group the number of cases are respectively36cases (38.3%),15cases (16.0%) and43cases (45.7%). A total of79cases having described the infiltration layer, divided as T1、T2、T3、T4group, the proportion is respectively19.0%(15cases),24.1%(19cases),13.9%(11cases),43.0%(34cases).Pathological grading information was reported in107cases, of which the G153cases (49.5%), G215cases (14.1%), and G339cases (36.4%). The positive rate of Syn and CgA is respectively99.1%(109/110) and72.2%(78/108).The difference in cases with different pathological grading about onset age, location, tumor size, T stage, lymph node metastasis and distant metastasis are statistically significant.6. There are treatment data of102cases, including67cases of surgical treatment, radical surgery of60cases, palliative surgery in7cases, endoscopic excision of26cases,9cases of no lesion resection. In67cases of surgical treatment, the report of lymph node is a total of54cases,36cases with lymph node metastasis. Sweeping the lymph node for a total of1086, the number of positive for192, the positive rate is17.7%. In the12cases with distant metastasis,8has been given surgical treatment,4cases with conservative treatment. The main part of distant metastasis is liver (5/12).7. We followed up97cases, the follow-up rate was86%, the follow-up time is1-43months, average follow-up time for17.5months, the median follow-up time for16months. Of the97cases,15cases died, the overall survival rate was84.5%.According to the results of survival analysis,tumor size, location, pathological grading, T stage, lymph node metastasis, distant metastasis, Ki-67positive index are all factors affecting the prognosis of patients.Conclusions1. Cases of GI-NENs are increasing year by year, of which men has a higher morbidity than women. People among all ages may get the disease.2. GI-NENs occur most in the stomach, followed by the rectum, while colon and small intestine are relatively rare.3. The vast majority of patients with GI-NEN show the nonspecific symptoms, patients with typical carcinoid syndrome is rare.4. The general form of GI-NEN is most ulcer type, uplift type and polyp type.5. Surgery is the main treatment method, and endoscopic resection applies to tumor with small size and shallow infiltration.6. The main means of preoperative examination is endoscopy and biopsy, CT^MRI can be used as auxiliary examination means, EUS has a very good application effect, and can be used in combined with common endoscopy.7. The Syn and CgA is the most commonly immunohistochemical index used in diagnosis, Syn has a higher positive rate, the joint detection has a higher accuracy.8. The difference in cases with different pathological grading about onset age, location, tumor size, T stage, lymph node metastasis and distant metastasis are statistically significant.9. Tumor size, location, pathological grading, T stage, lymph node metastasis, distant metastasis, Ki-67positive index are all factors affecting the prognosis of patients. |
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