| Aim:Through the retrospective study of gastric neuroendocrine neoplasm(NEN)patients in two hospitals in Jiangsu province,the clinical manifestations,endoscopic characteristics and pathological diagnosis of gastric NEN were analyzed.Starting from the clinical subtypes,the crux of diverse endoscopic manifestations,invasion and metastasis,pathology and treatment were studied.The clinicopathological features of gastric NEN in different lesion sites were explored.The factors affecting the prognosis of the whole group and poorly differentiated NEN in the stomach were analyzed.Methods:Between February 2008 to December 2018,The clinical,endoscopic,pathological data and the prognosis of 148 patients diagnosed with gastric NEN by pathology in The First Affiliated Hospital of Soochow University or Jiangsu Province Hospital were collected.T test and chi-square test were performed to explore differences in the gender,age,endoscopic features,lymph node or organ metastasis and pathological differentiation of gastric NEN patients with different clinical subtypes,and to analyze the clinical symptoms,endoscopic manifestations,infiltration and metastasis of gastric NEN in different lesion sites.The log-rank test and Cox regression model were used to do the survival analysis of patients with gastric NEN as well as the patients with low differentiation gastric NEN.Results:The average age of gastric NEN patients was(61.55±10.513)years old,and that of the male(63.31±9.982 years old)was higher than that of the female(56.27±10.426 years old),the difference was statistically significant(t=3.593,P=0.001).No obvious specificity in the clinical symptom.19(86.4%)of the patients with choking on food were found cardia NEN,and a correlation was between choking and cardiac lesions(P=0.000).Chi-square test showed that the distinction between gastric NEN with type III and type non-III in the gender,age,region,gastroscopic characteristics(lesion size,morphology,number),pathological differentiation,metastasis were different(each P<0.05).The gastroscopic features,clinical subtypes,pathological differentiation,infiltration and metastasis of NEN in cardiac/gastric angle and other sites were different(all P<0.05).Univariate survival analysis suggested that the age,lesion morphology,lesion size,number of lesions,metastasis,clinical subtypes,and pathological differentiation of gastric NEN patients were all related to the prognosis(each P<0.05).Multivariate survival analysis found that clinical subtypes,lymph node or organ metastasis metastasis were risk factors for prognosis(P=0.043,0.015).In this study,only 2 patients with highly differentiated gastric NEN died during follow-up period,while 40 patients with poor differentiation died.Survival analysis of low-differentiated gastric NEN was performed.Univariate and multivariate prognostic analyses showed that lymph node infiltration or organ metastasis was associated with prognosis in patients with poorly differentiated tumors(p=0.043).Conclusions:Patients with different clinical subtypes of NEN in stomach have different endoscopic manifestations,metastasis of lymph nodes or organs,and pathological grade.Gastric NEN patients with type ? had a poorer prognosis than that with type non-?.The prognosis of patients with lymph node or organ metastasis was worse than that of patients with localized disease.Further survival analysis of the poorly differentiated gastric NEN revealed that lymph node and distant organ metastasis was of great significance to the prognosis of patients.It was suggested that medical staff should pay special attention to the diagnosis,treatment and prognosis evaluation of NEN patients with lymph node or organ metastasis. |
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