| ObjectiveTo investigate the clinical characteristic,diagnosis,treatment,pathological classification and relationship with survival of GEP-NEN,in order to improve the recognition of the disease.MethodsThe clinical data of the 97 GEP-NEN patients admitted in the First Affiliated Hospital of Anhui Medical University were retrospectively analyzed in December 2011 to December 2015.Results1.Sex ratio:of the 97 patients,64 cases were male and 33 were female,male-to-female ratio was 1.7:1.2.The onset age:the average age was 59.1 years at the age of 28-84.3.Primary site:there were 39 cases in the stomach,25 cases in rectum,11 cases in pancreas,9 cases in esophageal,8 cases in duodenum,2 cases in appendix,1 case in small intestine,back to the blind and the ascending colon.The site of gastric neuroendocrine tumor is also different.Of the 39 patients,12 patients located in cardia,19 cases in gastric body and 8 cases in gastric antrum.4.Clinical characteristic:of all the 97 cases,non-functional symptom accounts for 95.9%(93/97),while functional symptom accounts only for 4.1%(4/97).5.Diagnosis:endoscopy is a major mean to find GEP-NEN lesion.Of the 97 patients,46 cases were examined by gastroscope or colonoscopy and 43 cases were diagnosed by biopsy.CT,MRI,ultrasound,and endoscopic ultrasonography were often used to assist in making the diagnosis.In the pathological classification,high differentiated neuroendocrine tumor(G1 level)were 40 cases and G2 level were 11 cases.The positive rate of immunohistochemical diagnosis of chromogranin A and synaptophysin were 88%,97%,respectively.6.Treatment:97 patients were underwent surgery or endoscopic resection.Surgery include the radical surgery and palliative surgery.Endoscopic resection including endoscopic mucosal resection,endoscopic submucosal invisible,high-frequency electric coagulation resection and were treated with oxygen,etc.Of the gastric neuroendocrine tumor,only 1 case underwent endoscopic resection.However,20 cases of patients in colorectal NEN underwent endoscopic resection.If the patients lost the opportunity to operationIn,they can consider chemotherapy,biological treatment,molecular targeted therapy and radionuclide therapy.7.Statistical analysis:single factor survival analysis found that,in addition to the tumor stage,lymph node metastases and infiltrating depth,tumor site and age were also related to the prognosis of patients.Cox proportional hazards regression analysis also found that,in addition to the common tumor grade,infiltrating depth and lymph node metastasis(all P<0.05),gender and methods of surgery also affect the prognosis of patients with GEP-NEN(both P<0.05).The 1-and 3-year survival rates were 81.9%and 63.4%.Compared with gastrointestinal adenocarcinoma,the prognosis of the GEP-NEN is good.Conclusion1.GEP-NEN is a kind of relatively rare disease,men more than women,peaks at the age of 60-70.2.It may be found at any part of digestive system.The most common site is the occurrence of stomach.3.Most patients presented as non-functional tumors with non-specific symptoms.Preoperative diagnosis is difficult and only the pancreas NEN often have typical symptoms of hormone secretion easily to be diagnosed.4.The preoperative imaging studies of ultrasound,CT and MRI has better resolution to pancreas NEN.Endoscopy occupy the important position in the diagnosis of GEP-NEN.5.The pathological classification is given priority to with high differentiation and early stage.The positive rate of Chromogranin A(CgA)and synaptophysin(Syn)were high.They should be a regular testing index in GEP-NEN.6.The treatment of this tumor mainly depends on the operation.It can also use chemical drug treatment or molecular targeted therapy,etc.7.The prognosis of this tumor is correlated with the ages of patients,part of tumor,pathological grading,infiltrating extent,lymph node metastasis and surgical methods.The overall prognosis is good compared with gastrointestinal adenocarcinoma. |
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