胃肠道神经内分泌肿瘤74例临床分析  

The Clinical Analysis of 74 Cases with Gastrointestinal Neuroendocrine Neoplasm

作　　者：牛露伟 刘浩[2] 王凯[2] 付海啸[2] 符炜[2] 

机构地区：[1]徐州医学院研究生学院,江苏徐州221000 [2]徐州医学院附属医院胃肠外科,江苏徐州221000

出　　处：《中国普外基础与临床杂志》2016年第4期467-471,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨胃肠道神经内分泌肿瘤的临床特点以及治疗方案。方法回顾性统计2011年1月至2015年7月期间徐州医学院附属医院收治的74例胃肠道神经内分泌肿瘤患者的临床资料,并对其临床特点及治疗方案进行分析。结果胃肠道神经内分泌肿瘤的发病数逐年增加。共有74例胃肠道神经内分泌肿瘤患者,男47例,女27例,男女比例为1.74：1;年龄24～82岁,中位年龄57.5岁。肿瘤位于胃部最多（38例）,其次是直肠（23例）,结肠和十二指肠分别有12例和1例。肿瘤位于胃结肠者均无特异性的临床症状,位于直肠者中有腹泻表现者3例,即有功能性症状者占4.1%（3/74）,非功能性症状者占95.9%（71/74）。74例患者中行根治性手术者34例,内镜下切除者23例,共占77.0%（57/74）;另外行局部切除者8例,姑息性手术切除者4例,保守治疗者5例。淋巴结转移与患者性别以及肿瘤大小、浸润深度和分类相关（P〈0.05）,与肿瘤发生部位无关（P〉0.05）。术前远处转移与肿瘤大小和浸润深度相关（P〈0.05）。胃肠道神经内分泌肿瘤中,Syn检出阳性率为96.1%（49/51）,Cg A检出阳性率为72.9%（35/48）,两者之间的差异有统计学意义（P〈0.01）。结论胃肠道神经内分泌肿瘤发病数逐年增加,主要的治疗方案为根治性手术和内镜下治疗,Syn和Cg A的检测有利于神经内分泌肿瘤的诊断。Objective To investigate the clinical characteristic and treatment of gastrointestinal neuroendocrine neoplasm. Methods From January 2011 to July 2015, the clinical characteristic and treatment of 74 patients with gastrointestinal neuroendocrine neoplasm in The Affiliated Hospital of Xuzhou Medical College were retrospectively analyzed. Results Cases of gastrointestinal neuroendocrine neoplasm were increasing year by year. This study includes statistics of 74 patients. The number of male and female were 47 and 27, the rate was 1.74：1, the median age was 57.5 years old ranging from 24 up to 82 years. Of all the 74 cases, there were 38 cases（51.4%） in the stomach, 23 cases（31.1%） in rectum, 12 cases（16.2%） in colon, 1 case in duodenum. Of all the 74 cases with clinical symptom information, non-functional symptom accounts for 95.9%（71/74）, while functional symptom accounts only for 4.1%（3/74）. There were treatment data of 74 cases,including 34 cases in radical surgery, 23 cases in endoscopic excision, 8 cases in local resection, 4 cases in palliative resection, and 5cases in conservative treatment. The lymphatic metastasis was associated with gender, tumor size, tumor depth of invasion and tumor differentiation（P〈0.05）. There was no statistically significant between the lymphatic metastasis and tumor location（P〉0.05）. Preoperative distant metastasis was associated with tumor size and tumor depth of invasion（P〈0.05）. Syn had a higher positive rate than Cg A（P〈0.01）. The positive rate of Syn and Cg A was respectively 96.1%（49/51） and 72.9%（35/48）. Conclusions Cases of gastrointestinal neuroendocrine neoplasm are increasing year by year, of which men has a higher morbidity than women. Radical surgery and endoscopic resection are the main treatment methods. The Syn and Cg A test are helpful to the diagnosis of gastrointestinal neuroendocrine neoplasm.

关 键 词：神经内分泌肿瘤 胃肠道 外科手术 

分 类 号：R735[医药卫生—肿瘤]