胃神经内分泌癌42例预后分析  

Prognostic analysis of 42 patients with gastric neuroendocrine carcinoma

作　　者：寇玉[1] 高业博[1] 马杰[2] 杨科[2] 付强[3] 谢建国[3] 

机构地区：[1]河南中医学院第一附属医院普通外科,郑州450000 [2]郑州大学附属肿瘤医院病理科 [3]郑州大学附属肿瘤医院普通外科

出　　处：《中华胃肠外科杂志》2013年第6期570-573,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨胃神经内分泌癌（NEC）的临床病理特征及预后。方法回顾性分析2006年5月至2011年7月间郑州大学附属肿瘤医院收治42例胃NEC患者的临床资料，总结其临床病理特征，并通过Logrank检验分析影响患者预后的因素。结果42例胃NEC患者占同期收治胃癌的0．83％（42／5046），其中男性37例，女性5例，诊断年龄平均63岁。均接受手术治疗，其中R0切除者40例，R，切除者2例；术后有40例行常规氟尿嘧啶联合奥沙利铂辅助化疗。42例患者随访时间为4～70（中位26）月，中位生存时间为25月，1、3、5年总生存率分别为71．4％、26．2％和11．9％。单因素预后分析显示，肿瘤最大直径、肿瘤侵犯深度、淋巴结转移、淋巴管浸润、肿瘤分期及手术根治程度与患者预后有关（均P〈0．05）。结论胃NEC较为罕见，手术治疗是改善胃神经内分泌癌预后的关键，而术后综合治疗方案的选择仍需优化。Objective To investigate the clinicopathological characteristics and prognosis of gastric neuroendocrine carcinoma （NEC）. Methods Clinical data of 42 patients with gastric neuroendocrine carcinoma admitted in the Cancer Hospital of Zhengzhou University between May 2006 and July 2011 were analyzed retrospectively. The prognostic factors were determined by Log-rank test. Results Gastric NEC was found in 42（0.83%） of 5046 patients with gastric cancer during the same period, including 37 males and 5 females. The average age of the patients was 63 years old at the diagnosis. Forty patients underwent R0 resection and 2 patients R1 resection. Forty patients received routine adjuvant chemotherapy with fluorouracil plus oxaliplatin. The median follow-up duration was 26.0 months （range 4-70 months）. The median survival was 25.0 months, and the overall 1-, 3-, 5-year survival rates were 71.4%, 26.2% and 11.9%, respectively. Univariate analysis revealed that maximum tumor diameter, tumor invasion depth, lymph node metastasis, lymphatic invasion, stage, and curability were associated with survival （all P〈0.05）. Conclusions Gastric NEC is rare. Curative operation is essential for improving the prognosis, while the choice of comprehensive treatment after surgery should be optimized.

关 键 词：胃肿瘤 神经内分泌癌 外科手术 预后 

分 类 号：R735[医药卫生—肿瘤]