Clinical Analysis Of Intestinal Neuroendocrine Neoplasm In 117 Cases

BackgroundNeuroendocrine neoplasms are a group of heterogeneous tumors consisting of cells that contain dense neuroendocrine-secreting particles in the cytoplasm,which are relatively rare and show different clinical manifestations.Over the past three decades,the incidence of neuroendocrine neoplasms has increased significantly.About two-thirds of neuroendocrine neoplasms occur in the gastrointestinal tract.Intestinal neuroendocrine neoplasms have a variety of clinical symptoms,some can be expressed as specific clinical symptoms caused by hormone secretion,some can be expressed as clinical symptoms missing or non-specific until the performance of liver metastases or acute local complications such as intestinal obstruction,perforation or bleeding.Therefore,our understanding of intestinal neuroendocrine tumors are still limited,and the current research on the intestinal neuroendocrine tumor is relatively small.This study collected 117 cases of gastrointestinal neuroendocrine tumors from January 2011 to September 2016 in the First Affiliated Hospital of Zhejiang University Medical College.The age of diagnosis,sex,the clinical symptoms,G grade,T stage,pathological type,whether distant metastasis,whether lymph node metastasis and survival prognosis were retrospectively summarized,analyzed and explored in order to deepen the understanding of this disease and to provide assistance for the future diagnosis and treatment of intestinal neuroendocrine neoplasms.Materials and MethodsFrom January 2011 to September 2016,all cases of intestinal neuroendocrine neoplasms were found in the medical record system of the First Affiliated Hospital of Zhejiang University Medical College.The basic data of the all patients were extracted by the medical record system,including the patient's name and sex,the age of the first diagnosis,the anatomical location of the disease,the pathological results of the tumors,whether there was distant metastasis(Including the site of the metastasis),the patient's first treatment method,the patient's telephone and address.The diagnosis of neuroendocrine neoplasms is based on WHO's 2010 classification and ENETS program.The main method of follow-up is by telephone.The deadline of follow-up is March 16,2017.Finally,impact of the relevant factors on patient's overall survival is analyzed by the method of Kaplan-Meier using IBM SPSS Software.ResultsThis study included 117 cases of intestinal neuroendocrine neoplasms from January 2011 to September 2016 in the First Affiliated Hospital of Zhejiang University Medical College.The number of patients increased year by year from 2011 to 2013.And the ratio of male and female patients was 2:1.The ages of the most patients range from 50 to59 5 and the average age of diagnosis is 52.03 years old.The most common site of the disease is located in the rectum,accounting for 77.78%of the total cases,followed by the small intestine and appendix.There were no clinical symptoms of functional neuroendocrine neoplasms in patients included in this study.The clinical symptoms of patients were non-specific such as abdominal pain and blood in the stool.Surgery is the first choice of patients in this study and patients with G1 rectal neuroendocrine neoplasms were predominantly treated by the method of TEM surgery.And the treatments of advanced intestinal neuroendocrine neoplasms include chemotherapy,targeted therapy,somatostatin analogues treatment and so on.By Kaplan-Meier statistical analysis,G-stage,T-stage,pathological type,whether lymph node metastasis,whether distant metastasis are closely related to the survival prognosis of the patients.ConclusionThe incidence of intestinal neuroendocrine tumors is increasing year by year,male patients are significantly more than female patients.The most common site of the disease is located in the rectum.The main method of treatment was surgery.The patients with late stage,the pathological type of neuroendocrine cancer and mixed neuroendocrine cancer,lymph node metastasis,distant metastasis have poorer survival prognosis.Thus,the early detection,early diagnosis and early treatment of intestinal neuroendocrine neoplasms are very important.