93例胃肠胰神经内分泌肿瘤的回顾性研究  

Retrospective study of relationship between clinical, pathological and prognostic characteristics of 93 cases of gastroenteropancreatic neuroendocrine neoplasm cases

作　　者：杨逸[1] 盛能全 阎钧[2] 龚剑锋[2] 王志刚[2] 

机构地区：[1]苏州大学医学部,江苏苏州215006 [2]上海交通大学附属第六人民医院普外科,上海200233

出　　处：《中国现代普通外科进展》2015年第4期279-284,共6页Chinese Journal of Current Advances in General Surgery

摘　　要：目的：探讨胃肠胰神经内分泌肿瘤（GEP-NENs）临床病理特征和预后.方法：回顾性研究上海交通大学附属第六人民医院2003年5月-2013年5月93例GEP-NENs患者的临床资料和随访数据.结果：男女比例1.4∶1,平均年龄57.1岁,发病高峰60～69岁.病灶位于直肠（31.2％）、胰腺（25.8％）、胃（18.3％）、阑尾（12.9％）、十二指肠（8.6％）、结肠（2.1％）、输卵管（1.1％）.其中,非功能性GEP-NENs占84.9％,无特异临床表现,多见腹部胀痛（63.4％）、消化道出血（28.0％）等,内镜及影像学检查多提示占位性病灶.84例患者获得成功病理复片,其中神经内分泌瘤（NET）占73.8％,神经内分泌癌（NEC）占23.8％,混合性腺神经内分泌癌（MANEC）占2.4％;G1、G2和G3级GEP-NENs分别占52.4％、21.4％和26.2％.初诊时,52.5％的患者肿瘤浸润肌层/浆膜层,18.8％浸润周围组织,20.0％发生局部淋巴结转移,1 4.0％发生远处转移.91例患者接受手术治疗.随访1、3和5年生存率分别为89.5％、74.3％和65.8％.结论：GEP-NENs可发生于消化道任何部位,非功能性多见,临床表现缺乏特异性,确诊有赖于病理诊断.总体预后较好,肿瘤病理分级、分类、浸润深度和远处转移与预后相关.Objective：To investigate the clinical,pathological characteristics and relationship with survival of gastroenteropancreatic neuroendocrine neoplasms （GEP-NENs）.Methods：Medical records and follow up of 93 GEP-NENs patients in the Sixth Affiliated Hospital of Shanghai Jiaotong University from May 2003 to May 2013 were collected and analyzed respectively.Results：Male-to-female ratio was 1.4∶1 and the mean age was 57.1.Primary sites were rectum （31.2％）,pancreas （25.8％）,stomach （18.3％）,appendix （12.9％）,duodenum （8.6％）,colon （2.1％） and oviduct（1.1 ％）.Most patients presented as non-functional tumors（84.9％） with non-specific symptoms such as abdominal pain （63.4％） and gastrointestinal bleeding （28.0％）.The manifestations of endoscopy and radiographic image were tumor occupying lesion.84/93 GEP-NENs patients were diagnosed with neuroendocrine tumor （NET）（73.8％）,neuroendocrine carcinoma （NEC） （23.8％） or mixed adenoneuroendocrine carcinoma（MANEC） （2.4％）.The grading composition was G1 （52.4％）,G2 （21.4％） or G3 （26.2％）.At diagnosis,muscularis or serosa infiltration was found in 52.5％ GEP-NENs patients,adjacent tissue infiltration in 18.8％ patients,Ioco-lymphatic metastasis in 20.0％ cases and distant metastasis in 14.0％ cases.A total of 91 patients were underwent surgery.The 1-,3-and 5-year survival rates were 89.5％,74.3％ and 65.8％.Conclusions：GEP-NENs may be found at any part of digestive system.Most patients presented as non-functional tumors with non-specific symptoms.Final diagnosis is base on pathological detection.The prognosis of this tumor is correlated with the pathological classification,grading,infiltrating extent and distant metastasis.

关 键 词：神经内分泌肿瘤 临床 病理 预后 

分 类 号：R735[医药卫生—肿瘤]