消化系统神经内分泌肿瘤的临床分析  

Clinical diagnosis and treatment of neuroendocrine neoplasm in the digestive system

作　　者：王谊[1] 喻璟瑞[1] 向明飞[1] 李吉满[1] 

机构地区：[1]四川省肿瘤医院肿瘤内科,成都610041

出　　处：《中国肿瘤临床与康复》2012年第5期405-407,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨消化系统神经内分泌肿瘤的临床特征、诊断治疗方法及预后。方法回顾性分析2006年1月至2011年2月收治的17例消化道神经内分泌肿瘤的临床资料。结果免疫组织化学染色结果:突触素(Syn)阳性率94.1%(16/17),嗜铬蛋白A(CgA)阳性率70.6%(12/17);17例中有3例Ki-67<20%为中低级别神经内分泌瘤,其余均为高级别神经内分泌癌。本组中位生存时间OS为16个月(2～54个月)。7例有远处转移(M1Ⅳ期)患者中位OS为6个月,10例M0期患者中位OS为29个月。单因素分析TNM分期和根治术与患者预后有关(P<0.01)。结论肿瘤的分期是影响预后的关键因素,根治性手术仍是目前治疗消化系神经内分泌肿瘤最主要的方法,化疗对消化系统神经内分泌癌的作用不可忽视。Objective To analyze the clinical characteristics, diagnosis, treatment and prognosis of neuroendocrine neoplasm（NEN） in the digestive system in order to enchance the recognization of these diseases. Methods Clinical related factors of 17 patients with NEN in the digestive system from Jan 2006 to Feb 2011 were retrospectively reviewed. Results Immunohistochemistry staining showed that the positive rate of synaptophysin（Syn） and chromogranin A（CgA） was 94. 1% （16/17） and 70. 6% （12/17） respetive- ly. Three patients with Ki-67 〈 20% were diagnosed as moderate and low grade neuroendocrine tumor （NET）, the others were high-grade neuroendocrine carcinoma （NEC）. The median survival time was 16 months （range,2-54 months） of the 17 patients. The median survival time of the 7 patients with the distant metastasis（ M1, IV stage） was 6 months, which was significantly shorter than those with M0 stage （29 months）. Cox univariate analysis revealed that TNM stage and radical surgical resection were prognostic fac- tors （P 〈 0.01 ） of NEN in the digestive system. Conclusions Staging is a key factor associated with prog- nosis. Radical surgical resection remains a main therapeutic approach of NEN in the digestive system. Chemotherapy is also important for the treatement of NEC in the digestive system.

关 键 词：神经内分泌肿瘤 临床特征 诊断 冶疗 

分 类 号：R735[医药卫生—肿瘤]