神经内分泌瘤252例临床分析  

Neuroendocrine tumors： analysis of 252 cases

作　　者：依荷芭丽·迟[1] 姜文昌 杜丰[1] 孙永坤[1] 宋岩[1] 杨林[1] 周爱萍[1] 王金万[1] 

机构地区：[1]中国医学科学院肿瘤医院内科,100021 [2]山东省青州市人民医院肿瘤科

出　　处：《中华肿瘤杂志》2013年第1期67-70,共4页Chinese Journal of Oncology

摘　　要：目的探讨神经内分泌瘤（NET）的发病、诊断和治疗。方法回顾性分析2004年1月至2009年12月中国医学科学院肿瘤医院有病案记录的252例NET患者的临床资料，包括发病年龄、初诊症状、原发部位、病理诊断、确诊病期、治疗情况和随访。结果男女之比为1．9：1，平均年龄为55．2岁，发病高峰为60～69岁。病灶位于消化道117例（46．4％），肺74例（29．4％），其他部位61例（24．2％），原发灶不明2例（0．8％）。不同原发部位患者的首发症状各不相同。肺原发患者常见的症状为咳嗽（48．0％）和痰中带血（22．7％）。直肠原发患者常见的症状为大便习惯的改变（29．3％）、腹泻和便秘（17．2％）。胃原发患者多表现为上腹部不适（86．4％）。类癌110例（43．7％），神经内分泌癌108例（42．9％），非典型类癌23例（9．1％），神经内分泌肿瘤5例（2．0％），梅克尔氏细胞瘤4例（1．6％），复合型类癌2例（0．8％）。180例（71．4％）患者为I～Ⅲ期。206例（81．7％）患者接受手术治疗，39例（15．5％）接受化疗，31例（12．3％）接受姑息性放射治疗。结论NET患者男性多于女性。消化道原发最为常见，其次为肺部原发。不同发病部位患者首诊症状不同。多数患者能够经过手术治疗、化学治疗和姑息性放射治疗获得良好预后。Objective To investigate the epidemiology, diagnosis, and treatment status of neuroendocrine tumors （NETs） in our hospital. Methods Medical records of 252 patients with neuroendocrine tumors diagnosed and treated in our hospital from January 1, 2004 to December 31, 2009 were collected and retrospectively reviewed in this study. The clinicopathological data including age of onset, initial symptoms, primary site, pathological conditions （Sny, CgA, Ki-67 ）, disease stage at diagnosis, treatment, and follow up were analyzed. Results The gender ratio M/F of the 252 cases was 1.9： 1, with mean age of 55.2 years, and the high incidence was in age of 60-69 years. The tumors were located in the gastrointestinal tract （117 cases, 46.4% ）, broncho-pulmonary system （74 cases, 29.4% ）, other sites （61 cases, 24.2%） and unknown primary site （2 cases, 0. 8%）. Their first clinical symptoms vary, depending on the primary site. The common symptoms of primary rectal NETs were changes in bowel habits （29.3%） and diarrhea or constipation （17.5%）, and most gastric NETs presented epigastric discomfort （86.4%）. Most patients （71.4%） were diagnosed with stage I ,Ⅱ , Ⅲ disease. Among the 252 cases, there were 110 carcinoids （43.7%） , 108 neuroendocrine carcinomas （42.9%） , 23 atypical carcinoids （9. 1% ）, five neuroendocrine tumors （ 2.0% ）, four Merkel cell tumors （ 1.6% ）, and two composite carcinoids （0.8%）. 206 patients （81.7%） received surgery, 39 （15.5%） received chemotherapy, and 31 cases （ 12.3% ） were treated by palliative radiotherapy. Conclusions This single-center retrospective analysis of data demonstreted that males have a higher incidence rate than females. The most common primary sites of NETs are the digestive tract and lungs. The initial symptoms of NETs are different depending on their primary sites. Good prognosis can be achieved in the majority of patients after surgery, chemotherapy and palliative radiotherapy.

关 键 词：神经内分泌瘤 诊断 治疗 预后 

分 类 号：R739.4[医药卫生—肿瘤]