Clinical Features And Prognostic Factors Of Gastrointestinal Neuroendocrine Tumors In Chinese Population:A Systematic Review And Meta Analysis

objective: Gastrointestinal neuroendocrine tumors(GI-NETs)is a type of relatively uncommon malignant tumor with a low incidence.The clinical characteristics and prognostic factors of these tumors are poorly understood because of their clinical rarity and the lack of a comprehensive database in China.In this paper,the literature on gastrointestinal neuroendocrine tumors in Chinese population was reviewed systematically to further clarify its clinical characteristics and prognostic factors.Methods : We searched PubMed,EMBASE,Cochrane Library,CNKI,CBM,wanfang,VIP and other databases,and obtained all literatures from September 2010 to September 2018.The effects of age,sex,tumor site,tumor size and pathological grade on the 5-year survival rate of GI-NETs patients were summarized.Results the pooled risk ratio(HR)and 95% confidence interval(95%CI)were used to evaluate.Results: A total of 23 articles were enrolled in the analysis,and a number of 2616 patients with GI-NETs were included,among whom 1733 were males and 883 were females,with a male to female ratio of 1.96:1.The age of onset was 14-87 years old,and the the most common age was 40-69 years old,among which 50-59 years old was the highest incidence.In terms of the primary tumor site,the most common tumor was in rectum(63%),followed by stomach(26%).At the time of diagnosis,61% were in G1 phase;G2 phase accounted for 11%;G3 phase accounted for 28%.The study showed that the 5-year survival rate of GI-NETs patients was significant differences in gender(male and female)of(HR:1.287,(1.102-1.504),P< 0.005);Age(>60 years old and<60 years old)(HR:1.546,(1.314-1.818),P < 0.005);Tumor size(> 2cm and< 2cm)(HR:2.198,(1.814-2.663),P < 0.005);Tumor site(stomach and intestine)(HR:1.485,(1.300-1.697),P < 0.005);Pathological grading(G3 and G1+G2)(HR:2.611,(2.206-3.091),P < 0.005);T staging(T3+T4 and T1+T2)(HR:2.382,(1.972-2.876),P=0.005);Lymph node metastasis(Yes and no)(HR:2.001,(1.673-2.395),P<0.005);Distant metastasis(Yes and no)(HR:3.188,(2.317-4.385),P< 0.005);Treatment(non-surgical and surgical)(HR:4.609,(2.826-7.516),P< 0.005).Conclusion: In Chinese population,GI-NETs is more common in middle-aged and elderly people,especially in men.Rectum is the most common site of disease,followed by stomach,and most of them are in G1 stage and G2 stage with a good prognosis,while G3 stage accounts for a small proportion.Meta analysis showed that gender,age,tumor size,tumor site,pathological grading,depth of invasion,lymph node metastasis,distant metastasis and treatment methods were all risk factors affecting the survival and prognosis of GI-NETs patients.In clinical work,we need to comprehensively evaluate these risk factors,so as to have a more accurate grasp of the prognosis of GI-NETs patients and timely adjust the treatment plan.