Neuroendocrine Neoplasms Of Digestive Tract In82Cases:Clinical Analysis

Objective:To study the incidence rate, inheritance tendency, clinical characteristics, diagnosis, validity of drugs, prognosis of the digestive tract neuroendocrine tumors, and try to help improve the clinical diagnosis and treatment of these diseases.Material:The study contains82patients with neuroendocrine tumors of digestive tract, all of them received surgical operations from Qilu Hospital between2005.7and2012.11. Among these patients, there are58male and24female, the rate is2.42to1. Their age varies from20to79, and the median age is55.5. All the pathological sections were examined with immunochemical methods and calculated the positive rates of CgA and Syn.Methods:A follow-up study of all the patients was made to analyze the disease. And this study mainly analyzed the clinical features, efficiency of surgical operations, drug efficiency, survival rate and so on, then drawn some conclusions of these data.Results:1. Of all the patients, the numbers of male and female are58and24, the rate is2.42:1. Male are more likely to suffer from NENs. Most patients are50to70years old, the median age is55.5. Male and the old are the common patients of the disease.2. No family aggregation and heritability were found in this study. All cases are independent and without apparent pattern.3. The NENs of the digestive tract have a high rate of diagnosis mistake. Even after the digestive endoscopic examination, without a pathological diagnosis, the rate of an erroneous diagnosis is still very high (about92.5%). The NENs with typical clinical characteristics are more likely to be diagnosed correctly.4. The typical characteristics of carcinoid syndrome in GI-NENs are not as common as expected. Diarrhea and flushing are the most common characteristics of carcinoid syndrome, with the rates of58.54%and69.51%.5. The silver staining of the pathological sections has less specificity than immunohistochemistry in the diagnosis of NENs. CgA and Syn are the most common substance to indicate the NENs, and the sensitivity of Syn is higher than CgA.6. Patients have a worse prognosis if they are male or have these features:large tumors, apparent tumor invasion, metastasis, typical clinical carcinoid characteristics and without usage of drugs.Conclusions:1. The neuroendocrine neoplasm is a kind of heterogeneous tumor in the digestive tract with a relatively low incidence rate, however, it is getting more and more common in current time.2. Many factors influence the incidence rate of GEP-NENs, for example, male have a higher chance to get the disease. People among all ages can get the disease, but the most common age is between50and70.3. The clinical characteristics vary depending on people. The carcinoid syndrome is not as common as expected. These, however, make the diagnosis a challenge to doctors. Pathologic diagnosis is the most important method for GEP-NENs.4. Surgical operation is the most important way to treat the disease. Many drugs can be used as the secondary treatments. Also, they can be used in carcinoid syndrome. 5. The prognosis is affected by many factors. For example, sex, the volume of the tumor, the invasive depth, metastasis, drugs, et al.