| Objective This research aims to summarize and analyze the clinical features, pathological characteristics, diagnostic methods, treatment modalities and prognosis of gastroenteropancreatic neuroendocrine tumors(GEP-NENs). Find out the relationship between the clinical characteristics and factors affecting prognosis of GEP-NENs in China and provide the basis for clinical doctor to diagnose and treatment these diseases.Methods Totally 108 patients with GEP-NENs diagnosed by immunohistochemical staining in Xijing Hospital of Digestive Diseases, Fourth Military Medical University, from January 2008 to December 2013 were analyzed retrospectively about their clinical manifestations, pathological features, diagnostic methods, treatment and prognosis.Results Among the 108 patients with GEP-NENs, 58(53.7%) were men and 50(46.3%) were women. Male-to-female ratio was 1.16:1.Their ages were between 17-78 years old(with the average age of 50.90±12.94 years). The minimum of the tumor was 0.2 cm; the maximum was 13.2 cm; the average was 1.90±1.94 cm. The places of occurrence were successively pancreas-43 cases(39.8%), rectum-25 cases(23.1%), stomach-19 cases(17.6%), duodenum-8 cases in(7.4%), ileum- 3 cases(2.8%), appendix-3 cases(2.8%), colon-3 cases(2.8%), cardia- 2 cases(1.9%), jejunum- 2 cases(1.9%). The clinical symptom manifested 32 cases(29.6%) with epigastria and back pain, 20 patients(18.5%) with abdominal bloating, 17 patients(15.7%) with pallor, sweating and heart-beat, 8 cases with Lower abdominal pain. 18 cases(16.7%) were found by health examinations. Pathology of GEP-NENs can be classified as: 30 cases of neuroendocrine tumor, 9 cases of neuroendocrine carcinoma. According to differentiation,low grade(G1) NENs included 57 cases(52.8%), intermediate-grade NENs(G2) 39 eases(36.1%),and high grade 12 cases(11.1%)(G3). The results of immunohistochemistry indicated 97.2% of Syn positive rate, 90.7% of CD56 positive rate, 86.1% of AE1/AE3 positive rate, 74.1% of CgA positive rate. 103 patients underwent the surgery with radical resection(72 cases) and Endoscopic submucosal tumor decollement(21 cases).Transanal Endoscopic Microsurgery was performed on 8 patients. 1 case was treated by high intensity focused ultrasound knife.1 case was treated by argon helium cryoablation under the guidance of CT. The 3-year survival rate was 87.1%.Conclusion The number of GEP-NENs is increasing year by year. There was no significant difference between male and female. But female had a higher morbidity than male in functional GEP-NENs. Clinical manifestations were lack of specificity, and immunohistochemical staining need to be combined with imaging examination. Pancreas was the most common site of GEP-NENs. Surgical treatment was the most effective way to GEP-NENs and improved the prognosis of the patients significantly. The prognosis was affected by many factors, such as pathological type, tumor grade, clinical stage, nonfunctional tumors, the volume of the tumor, Ki67, lymph node metastasis and metastasis, et al. Multivariate analysis showed independent risk factors were tumor size and lymphatic metastasis. |
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