Clinicopathological And Prognostic Features Of Rectal Neuroendocrine Tumor

Objective：To study Clinicopathological characteristics and the related prognosticfactors of rectal neuroendocrine tumor.Methods:1.Data collection: Using a doctorworkstation and endoscopy center two databases In the General hospital of PLA, weidentified the patients who carried a diagnosis of rectal carcinoid tumor orneuroendocrine tumor on a pathology report between January2001and June2012.6.Pathological grading and staging: According to WHO in2010new gradingstandard for gastrointestinal pancreatic neuroendocrine tumor, we reclassified those inwhich pathological record was not list by a pathologist.3.Data analysis:Data elements,retrospectively were been entered onto the database,included patients ages, gender,symptoms at presentation, treatment, clinical size and location of tumor indicated atendoscopy,pathologic features, clinical and endoscopic follow-up, and detailssurrounding mortality.Single factor and multivariate analysis were performed to findrelated prognostic factors. And we further evaluate the efficacy and safety of endoscopictreatment.Results:1.A tota1of153cases of rectal neuroendocrine tumors werediagnosed endoscopical1y,Of130(85%,130/153)patients receiving endoscopictherapy.Those patients (103cases)who had received endoscopic treatment successfully(margin negative)were follow-up through telephone, average follow-up time was3.95±2.50years(rang1.0~12.3yeas), no recurrence and metastasis.2patients(1.5%,2/130)developed delayed bleeding,the patients recovered after receiving endoscopichemostasis and conservative treatment. The classic endoscopic characters of rectalneuroendocrine tumors were submucosal tumor with yellow color and rigid or toughtexture.2.Among the183patients,there were158cases of grade1tumors,21cases ofgrade2tumors and3cases of grade3tumors.5year survival rates of the G1, G2were98.73%,76.19%.4cases of poorly differentiated neuroendocrine carcinoma (G3), only one case was still alive during2years’ follow-up time.The remaining3cases survivedfor3to10to18months after operation respectively,and were found liver metastases.pathological grading between the three grounds survival difference was statisticallysignificant (P <0.05).Rectal neuroendocrine tumor patients with different grade weresignificantly different in tumor size, pathological stage,lymph node metastasis (P <0.05).3.Among the183patients,the overall5-year survival rate was92.3%,single factoranalysis showed that tumor size,pathological grading and the stage between the threevariables survival difference was statistically significant.multivariate analysis (Coxregression) shows that the tumor stage were independent factors affecting the prognosisConclusions:1.Endoscopic classic characters helps to improve the diagnosis of rectalneuroendocrine tumor, and endoscopic treatment is safe and effective for those tumorswhich are small and limited to mucosa or submucosa.2.Rectal neuroendocrine tumorwith different pathological grading have a different prognosis. New classification in2010is useful to asses the prognosis of NEN,we should find its way into clinicalreality.3.Tumor staging is an independent risk factor of rectal neuroendocrine survival.