Clinical Features And Prognosis Of Colorectal Neuroendocrine Neoplasms

Objective:Neuroendocrine neoplasm(NENs)is a class of tumors that derived from neuroendocrine cells.However,with the further study of the tumor and the improvement of the means of examination,the detection rate of this tumor is obviously higher than before.NENs can occur in all organs of the body,the digestive tract is the main predilection site,and colorectal NENs accounts for about 70% of the total digestive tract NENs.Methods:48 cases of colorectal NENss clinical data were retrospective collection in Tianjin Medical University General Hospital.The information mainly includes the patient’s clinical manifestation,the pathological result and the treatment method.They were grouped according to different stages of pathology and treatments.Through the statistical analysis of the results,we can get the related clinical factors that affect the prognosis of the disease.Results:In the 48 patients with colorectal NENs,30 were male(62.5%)and 18 were female(37.5%).The patients with stage G1 were 35 cases and 2 of patients with colonic NENs,the endoscopic treatment showed no metastasis and tumor recurrence.33 cases of rectal NENs patients,28 cases with tumor diameter less than 10 mm,25cases were treated with endoscopic resection of tumor,3 cases underwent resection of anal tumor,no postoperative metastasis occurred in distant patients,4 cases of tumor diameter ranged from 10mm~20mm,underwent transanal tumor resection,1 cases with tumor diameter 20 mm,endoscopic treatment after tumor positive margin underwent transanal tumor resection,postoperative had no tumor recurrence and distant metastasis.Among the 8 patients with stage G2,1 patients with colon NENs had a tumor diameter greater than 20 mm and underwent right radical colectomy without recurrence or metastasis.7 cases of rectal NENs patients,4 cases of tumor diameter ranged from 10mm~20mm,1 cases by surgery through the anus excision treatment,the patients fifteenth months after surgery for local recurrence tumor and in our hospital underwent laparoscopic assisted rectal anterior resection,postoperative follow-up without recurrence and transfer,3 cases no tumor recurrence and metastasis after surgery;3 cases of tumor diameter greater than 20 mm,the lesions invaded the serosa layer and muscle layer,laparoscopic assisted rectal low anterior resection,2cases after 12,20 months of local tumor recurrence and distant metastasis to liver,no significant improvement after palliative treatment,the patients were died,another 1patient without tumor recurrence and metastasis.Among the 5 patients with stage G3,2 cases of colon NENs patients,1 cases refused treatment,1 cases of palliative surgery,the patient died.3 patients with rectal NENs,1 cases underwent laparoscopic assisted abdomino perineal resection,postoperative follow-up of tumor distant metastases,tumor metastasis received symptomatic treatment,patients were alive,2cases underwent palliative surgery,postoperative death in patients with distant metastasis.Conclusions:1.NENs in the rectum than colon better.2.When the tumor is classified into stage G1,the colon NENs patients suggest endoscopic treatment;When the diameter of tumor in the rectum is less than 10 mm,endoscopic treatment is recommended for the patients with rectal NENs.The tumor diameter greater than 10 mm,endoscopic treatment may have a positive margin and need the possibility of extended resection,so when the tumor diameter greater than10 mm multiple choice anal tumor resection,achieve radical purpose.3.When the tumor pathological grading G2 stage,when the tumor diameter is less than 20 mm and not muscle invasive,surgical local excision was feasible.When the tumor invasion of the muscle layer or tumor diameter is greater than 20 mm,the radical resection should be carried out according to the resection scope of malignant tumor,so as to ensure the long-term survival rate of the patients.4.When the tumor pathological grading G3 stage,tumor diameter more than 20 mm,the treatment should be in accordance with the malignant tumor radical surgical resection treatment,postoperative combined chemotherapy and somatostatin treatment,the survival rate is low.