| Background: Neuroendocrine carcinoma(NEC) is a class of heterogeneoussystems from neuroendocrine tumors, rare in clinical practice, which has been reportedgastrointestinal cancer accounts for about0.4%-1.8%, occurred in the stomachneuroendocrine tumors are more scarce, but recent studies have found significantlyhigher incidence trends, the majority of patients due to the lack of typical clinicalmanifestations, and its biological characteristics, pathological features, the degree ofmalignancy and prognosis varied widely, its diagnosed mainly rely on pathologicaldiagnosis, lack of domestic and foreign scholars have a unified understanding that thejudgments clinical diagnosis and prognosis factors. This paper included18cases ofpathologically diagnosed cases of gastric neuroendocrine carcinoma, neuroendocrinecarcinoma of the stomach Exploration in clinical diagnosi, treatment and prognosis of anumber of factors that may affect, namely: age, gender, treatment time(from onset totreatment time), type of surgery(radical degree), lesion infiltration, lymph nodemetastasis and postoperative chemotherapy or not, such as the number of statisticalanalysis, to analyze the various factors of gastric neuroendocrine carcinoma prognosis,summary neuroendocrine factors and gastric cancer prognostic relevance.Materials and Methods: This study included in18cases in the SecondAffiliatedHospital of Dalian Medical University, since March2011to March2014, whichunderwent surgery, after surgery, diagnosed as gastric neuroendocrine cancer-relatedinformation, including: age, gender, treatment time (time from onset to treatment), themain clinical symptoms, endoscopy and Electronics abdominal CT examination,surgical procedures (whether to accept radical surgery) and postoperative chemotherapyor not were summarized, and several factors may influence the prognosis, namely: age,gender, treatment time, the extent of radical surgery, tumor infiltration: lymph nodemetastasis and postoperative chemotherapy or not the number of the analysis, which were divided into <60years and≥60years of age groups; gender into male and femalegroups; treatment time is divided into <3months,3to6months,6to12months and>12months four groups; surgical procedures of radical resection and palliative resectiongroups; based on the depth of invasion into the lesion: mucosal layer, serosa and distantorgan metastasis three groups; stomach is divided into the number of metastatic lymphnodes:0,1to2,3to6and>6four groups, divided into two groups according topostoperative chemotherapy or not. Univariate analysis using the Kaplan-Meier method,multivariate survival analysis using COX risk survival models to evaluate thecorrelation between the factors and prognosis.Results:18patients were obtained after surgery by phone, SMS or e-mailfollow-up: follow-up rate of100%, with a median survival time was14months,1yearand3-year survival rates were:66%and55.6%; COX univariate and multivariatesurvival analysis showed that:①Closely related to differences in treatment andprognosis of time (X2=14.356, P=0.002);②Extent of radical surgery, patientsreceived postoperative survival rate was significantly radical surgery group higher inpatients with palliative resection group (X2=24.873, P=0.001);③Lesions infiltration:infiltration to postoperative survival rate is higher than the mucosal layer serosa groupand distant organ involvement group, while patients with serous infiltration surgerygroup the survival rate is higher than the aid organ metastasis group (X2=7.706, P=0.021);④Number of lymph node metastasis: the increase of the number of lymph nodemetastasis of gastric case, the survival rate to decline,≤2lymph node metastasis inpatients undergoing the survival rate was significantly higher than other groups (X2=13.412, P=0.004);⑤Chemotherapy or Not: postoperative survival rate wassignificantly higher than the group receiving chemotherapy did not undergochemotherapy group (X2=2.414, P=0.012);⑥Age and Gender and Postoperativesurvival rate was no significant relationship. COX multivariate statistical survival modelresults indicate that the risk factors were independent prognostic factors of gastricneuroendocrine carcinoma (P<0.05), gender and age to their prognosis (P>0.05).Conclusion: Gastric neuroendocrine carcinoma is rare in clinical practice, no obvious clinical manifestations of specificity, no significant difference in thepreoperative diagnosis of pathological sexual and other types of cancer, serology,abdominal imaging appearance, echocardiography, blood and lung function are routineexamination, perioperative no special preparation, develop a reasonable basis for radicalgastrectomy surgical, surgical treatment choices based on the principles developed inthe case of surgery, postoperative diagnosis of the disease mainly depends onpathological diagnosis. The highly invasive pathology on the importance of highrecurrent decisions affecting the prognosis of many factors discussed in this paper forthe visiting time, surgical procedures, the degree of infiltration of the lesion, the numberof lymph node metastasis of gastric are factors and postoperative chemotherapy or not,etc. statistical studies, the results confirm the above five factors affecting the prognosisof gastric neuroendocrine carcinoma, and are independent factors; prognosis age andgender and stomach neuroendocrine carcinoma no significant correlation. Therefore,early treatment, complete excision of the lesion, the stomach is a lymph node dissectiongroup and give chemotherapy after surgery to improve the survival rate of gastricneuroendocrine carcinoma of great help. |
PDF Full Text Request