Clinical Features And Prognostic Analysis Of Gastrointestinal Neuroendocrine Neoplasm

Objective To analyze the clinical characteristics of gastrointestinal neuroendocrine neoplasm(GI-NEN)patients and explore the related factors affecting their prognosis.Methods The clinical data of 190 patients with GI-NEN confirmed by pathology in the General Hospital of Ningxia Medical University from January 2012 to December 2021 were collected,and their clinicopathological characteristics,treatment methods and prognostic factors were analyzed.Results 1.In this study,there were 190 patients with GI-NEN,including 128 males and62 females,with a ratio of 2.06:1.The age distribution range was 22-84 years old,and the average age was 56.88 ± 12.08 years old.2.The predilection sites of tumors were stomach in 110 cases(57.89%),rectum in 77cases(40.53%),duodenum in 2 cases(1.05%)and colon in 1 case(0.53%).3.There were 184 cases(96.8%)of non-functional GI-NEN and 6 cases(3.2%)of functional GI-NEN.4.The detection rate of GI-NEN general endoscopy was 98.4%(187/190),the detection rate of CT was 83.6%(97/116),and the diagnostic accuracy rate of EUS was 91.4%(53/58)..5.Immunohistochemical indexes: The positive rates of Syn,Cg A,CD56 and CK were97.9%,51.6%,88.6% and 75.0% respectively.There were 81 cases(42.6%)with Ki-67 positive index<3%,18 cases(9.5%)with 3-20%,and 91 cases(47.9%)with Ki-67 positive index>20%.Pathological classification: 110 cases(57.8%)of neuroendocrine tumor,59 cases(31.1%)of neuroendocrine carcinoma,21 cases(11.1%)of mixed neuroendocrine non-neuroendocrine neoplasm.Pathological grading: G1 grade 81 cases(42.6%),G2 grade 18cases(9.5%),G3 grade 91 cases(47.9%).Analysis of clinical characteristics among different pathological grades: the pathological grades of GI-NEN patients with male,age ≥ 60 years old,gastric location,tumor diameter>2cm,positive expression of Cg A and CD56,lymph node metastasis and distant metastasis were higher,and the differences were statistically significant(P<0.05).6.84 cases(44.2%)underwent surgical operation,85 cases(44.7%)underwent endoscopic treatment,16 cases(8.4%)underwent chemotherapy alone,and the other 5 cases(2.6%).7.A total of 184 patients were followed up,of which 6 were lost,with a loss rate of 3.1%,and 58 died.1.The 3-year and 5-year overall survival rates were 75.7%,60.8% and 51.1%respectively.Univariate analysis: age,sex,tumor location,tumor diameter,tumor classification,Ki-67 index,CD56 positive rate,lymph node metastasis and distant metastasis were the factors affecting the prognosis of GI-NEN patients(P<0.05);Multivariate analysis:Age and Ki-67 index were independent risk factors affecting the prognosis of GI-NEN patients(P<0.05).Conclusion 1.The clinical manifestations of GI-NEN patients are non-specific,and the diagnosis depends on histopathology.2.Surgery and endoscopic resection are the main treatment methods of GI-NEN.3.Age and Ki-67 index are independent risk factors affecting the prognosis of GI-NEN patients.