Clinical Features And Prognosis Analysis Of Gastrointestinal Neuroendocrine Neoplasm

Objective:Based on the analysis of the clinical and pathological data,this paper discusses the relationship between the prognosis of gastrointestinal neuroendocrine neoplasm,pathological features,classification and staging.Methods:Retrospective analysis was selected for the clinical data of 179 patients with GI-NET from January 2005 to July 2016 in Qilu Hospital.The primary endpoint was overall survival,discuss and analyze the relevance of pathological characteristics,treatment modalities,classification and staging between prognoses.Conditions of incorporation:The clinical data of the patients were complete and could be followed up by normal contact;Exclusion conditions:The clinical data were incomplete;patents that complicated with other tumors or die for other reasons;or contact error resulted in failure to follow up.Statistical analysis was performed using Kaplan-Meier method for single factor survival analysis,Log-rank test was used to compare survival rate,COX regression analysis was used for multivariate analysis,and then obtain the independent factors affecting the prognosis of GI-NENs.Results:The total number of cases confirmed by pathology was 179 cases;we followed up to 119 cases,among them,60 patients were not included in the discussion group because of incorrect contact and incomplete clinical data.In 119 patients,74 patients received surgical treatment,37 patients received endoscopic treatment and 8 patients received non operative treatment.18 patients died within 1 year and 28 patients died within 3 years,the 1 year survival rate was 83.9%,and the 3 years survival rate of was 64.2%.81 cases of male patients died in 24 cases,the mortality rate was 29.6%,38 cases of female patients died in 4 cases,the mortality rate was 10.5%.The clinical manifestations of the patients were not specific.G1 and G2 NETs were mostly detected by endoscopy.The clinical manifestations of G3 NETs are similar to gastrointestinal adenocarcinoma.The main treatment methods include surgery and endoscopic resection;postoperative chemotherapy usually used etoposide+ cisplatin.Univariate analysis with Kaplan-Meier method showed that gender,treatment,tumor location,tumor grade,tumor size,KI67 index,TNM stage,T stage,lymph node metastasis were correlated to tumor prognosis(P<0.05);age,whether R0 resection,postoperative chemotherapy,with or without vascular invasion,CgA and Syn were not correlated to tumor prognosis(P>0.05).Multivariate analysis showed that tumor grade,TNM stage and T stage were independent prognostic factors of gastrointestinal neuroendocrine neoplasm.The pathological diagnosis of 119 cases of patients,the expression rate of Syn was 100%,CgA(+)expression rate was 63.9%(76/119),CgA(-)expression rate was 31.9%(38/119),CgA(+/-)expression rate was 4.2%(5/119).According to the x2 test,the expression of CgA was not correlated with gender,age,tumor grade,TNM stage,tumor size,T stage and KI-67(P>0.05);But,it was correlated with lymph node metastasis(x2=6.314,P=0.013)and tumor site(x2=19.876,P=0.000).Conclusions:The clinical manifestations of the patients were not specific.G1 and G2 NETs were mostly detected by endoscopy.The clinical manifestations of G3 NETs are similar to gastrointestinal adenocarcinoma.The diagnosis was based on pathological diagnosis,CgA,Syn and KI67 index were relatively specific pathological indicators,and there was no significant correlation with prognosis.The main treatment methods include surgery and endoscopic resection.The TNM stage and T stage were independent risk factors for tumor prognosis.