| Objective:Neuroendocrine tumors are heterogeneous tumors arising from peptidergic neurons and neuroendocrine tumor cells and are common in the digestive tract system.The aim of this study was to analyze the clinicopathological features and prognostic survival of patients with gastrointestinal neuroendocrine tumors in our hospital,hoping to attract the attention of clinicians to gastrointestinal endocrine tumors.Method:A total of 74 patients who visited China-Japan Friendship Hospital of Jilin University from January 2018 to March 2019 and were pathologically diagnosed with GI-NENs were collected.Through retrospective analysis and follow-up,the gender,age of onset,primary tumor site,clinical manifestations,preoperative auxiliary examination,treatment,postoperative pathological characteristics and postoperative survival of patients were counted.SPSS 26.0 software was used to analyze the general clinical data,pathological data,prognosis and survival of patients.Results:1.In this study,a total of 74 patients met the inclusion criteria,including 49 male patients and 25 female patients,with a male to female ratio of 1.96:1.The age of onset ranged from 25 to 79 years,and the age was 53 years.2.The rectum（67.6%）was the most common in 74 patients with GI-NENs,followed by the stomach（17.6%）,followed by the colon（8.1%）and small intestine（6.8%）.3.Of the 74 patients included in this study,91.9%（68/74）had non-functional symptoms and 8.1%（6/74）had functional symptoms（with carcinoid syndrome manifestations such as diarrhea,facial flushing）..4.The detection rate of preoperative CT was 43.5%,the detection rate of endoscopic ultrasonography was 100%,and the diagnostic accuracy was 88.5%.5.In terms of gross morphology,70.3%（52/74）were elevated,14.9%（11/74）were ulcer,8.1%（6/74）were polyp,4.1%（3/74）were nodular,and 2.7%（2/74）were erosive.Among them,ulcer type was predominant in 46.2% of the stomach and elevated type in 92% of the rectum.The maximum diameter of the tumor reached 15 cm and the minimum diameter of the tumor reached 0.1 cm.Tumor diameter was < 1cm in 64.9%（48/74）,1 – 2 cm in 10.8%（8/74）,and > 2 cm in 24.3%（18/74）.In terms of clinical stage,72.9%（54/74）of patients were in stage I,8.1%（6/74）in stage II,12.2%（9/74）in stage III,and 6.8%（5/74）in stage IV.T1 accounted for 72.9%（54/74）,T2 for 8.1%（6/74）,T3 for 14.9%（11/74）,and T4 for 4.1%（3/74）.N0 accounted for 82.4%（61/74）;N1 for 10.8%（8/74）;and N2 for 6.8%（5/74）.The liver is a common site of metastasis in GI-NENs.In terms of pathological classification,79.7%（59/74）had NET,14.9%（11/74）had NEC,and 5.4%（4/74）had MANEC.6.The positive rates of Syn,Cg A,CD56,CK,and vimentin were 95.9%,60.7%,68.9%,79.7%,and 67.6%,respectively.The positive rates of Syn,CD56,and CK were not correlated with the primary tumor site（P > 0.05）,and the positive rates of Cg A and vimentin were correlated with the tumor site（P < 0.05）.7.In terms of pathological grade,G1 accounted for 73%（54/74）,G2 accounted for 6.7%（5/74）,and G3 accounted for 20.3%（15/74）.There were significant differences in age of onset（X2 = 8.8418,P = 0.012）,gender（X2 = 11.476,P = 0.003）,tumor location（X2 = 30.374,P = 0.000）,maximum tumor diameter（X2 = 53.211,P =0.000）,T stage（X2 = 72.641,P = 0.000）,vascular invasion（X2 = 21.635,P = 0.000）,nerve invasion（X2 = 11.104,P = 0.003）,regional lymph node metastasis（X2 = 21.082,P = 0.000）,initial distant metastasis（X2 = 13.384,P = 0.001）and vimentin positive rate（X2 = 6.367,P = 0.031）between cases with different pathological grades.8.The treatment of 74 patients included in this study was statistically analyzed,32 patients underwent surgical treatment,41 patients underwent endoscopic treatment,and 1 patient did not undergo any treatment.There were a total of 6 patients who underwent chemotherapy,all of whom had postoperative chemotherapy and chemotherapy was mostly irregular.9.A total of 68 of 74 patients were followed up and 6 were lost to follow-up,with a loss rate of 8.1%.The follow-up time was 7-48 months,and the follow-up time was37 months.Of the 68 patients followed up,9 died and 9 died of extensive tumor metastasis.The overall survival rate was 86.8%.By univariate analysis,gender（X2 =5.075,P = 0.024）,tumor location（X2 = 9.797,P = 0.007）,maximum tumor diameter（X2 = 32.352,P = 0.000）,T stage（X2 = 73.771,P = 0.000）,presence or absence of vascular invasion（X2 = 16.838,P = 0.000）,presence or absence of nerve invasion（X2= 30.833,P = 0.000）,presence or absence of regional lymph node metastasis（X2 =6.870,P = 0.009）,presence or absence of distant metastasis（X2 = 31.744,P = 0.000）,vimentin positive rate（X2 = 4.411,P = 0.036）,Ki-67 index（X2 = 32.772,P = 0.000） and clinical stage（X2 = 81.907,P = 0.000）were all factors affecting the prognosis of patients,and clinical stage was an independent prognostic factor for patients with GI-NENs.Conclusion:1.The peak incidence of GI-NEN is 50-59 years old,and its incidence is related to gender,which is significantly higher in males than in females.GI-NEN is good for the rectum,followed by the stomach,and finally the colon and small intestine.2.There are differences in age of onset,gender,tumor location,maximum tumor diameter,T stage,vascular invasion),nerve invasion,regional lymph node metastasis,initial distant metastasis and vimentin positive rate among cases with different pathological grades.3.The prognostic survival of patients with GI-NENs is related to various factors such as gender,tumor location,maximum tumor diameter,T stage,presence or absence of vascular invasion,presence or absence of nerve invasion,presence or absence of regional lymph node metastasis,presence or absence of distant metastasis,vimentin positive rate,Ki-67 index and clinical stage,and clinical stage is an independent prognostic factor for patients with GI-NENs. |
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