Clinical Analysis Of 112 Cases Of Gastroenteropancreatic Neuroendocrine Neoplasms

Objective:This paper mainly focuses on the clinical features, pathological features of 112 cases of gastrointestinal and pancreatic neuroendocrine neoplasms. The purpose is to improve the knowledge of the level of diagnosis and treatment of diseases and to reduce the misdiagnosis and missed diagnosis.Methods:We collects the clinical data of 112 patients with gastroenteropancreatic neuroendocrine neoplasms(GEP-NEN), who were diagnosed by operation and pathology in Shanxi Provincial Tumor Hospital dating from January, 2009 to January, 2014. In this present paper, the clinical manifestations, endoscopic, pathological manifestations,diagnosis and treatment were retrospectively analyzed.Results:(1) This group of gastroenteropancreatic neuroendocrine neoplasms in 112 cases includes 91 cases from male, 21 cases from female, and their ages are between 39-78 years old(the average age of 59.54 + 10.05 years).(2) The stomach is the most common site of GEP-NEN(64%),which are followed by the esophagus in 16 patient(14%),the rectum in8 patients(7%),the duodenum in 3 patients(3%),the colon in 5 patients,the gallbladder in5 patients(4%),the pancreas in 1 patients,the small bowel in 1 patients(0.8%).(3) The main symptoms were abdominal pain, abdominal distension, dysphagia. One of the most common symptoms are abdominal pain,total of 33 cases(29%),abdominal distension in26 patients(23%),dysphagia in 23 patients(20%).(4) The diameters of 22 cases of 112patients with GEP-NEN are less than or equal to 2cm,those of 90 cases are greater than 2cm diameter, 13 cases with local lymph node metastasis,17 cases in distant metastasis.(5)80 cases of 112 patients underwent surgical treatment, 32 patients underwent surgical treatment and chemotherapy.(6) The positive rate of immunohistochemical diagnosis of chromogranin A and synaptophysin were 71%, 99% respectively.(7) The metastasis and lesion depth of this tumor is related. When the invasion depth is increased, metastatic rate is also increased. The histological type and tumor size, depth of invasion, tumor markers CEA, CA242 are closely related(X2=37.958、12.987,8.898、6.524,P<0.05).(8) The higher tumor TNM stage, the higher tumor histological type classification, and the correlation coefficient is 0.34651,P=0.0002.(9) At the same time, the higher the grade of histological types is, the more the tumor marker of abnormal is.(10) The metastasis may be one of the important factors for the prognosis of Gastroenteropancreatic Neuroendocrine Neoplasms.Conclusions:The gastroenteropancreatic neuroendocrine neoplasms are rare. The clinical manifestation is not typical. The most common site is the occurrence of stomach. A lot of confirmed cases are already late. Diagnosis depends on pathological examination and the combined detection of CGA, SYN. The treatment of this tumor mainly depends on the operation.