99例直肠神经内分泌肿瘤的临床特征和预后分析  

Clinical characteristics and prognosis in patients with rectal neuroendocrine tumors

作　　者：范振列[1] 张海瑞[2] 袁兴华[1] 马莉[2] 

机构地区：[1]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院,北京100021 [2]大连医科大学流行病与统计学教研室,大连116044

出　　处：《中国肿瘤临床与康复》2017年第3期288-291,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨大连地区直肠神经内分泌肿瘤患者的临床病理特征和预后。方法回顾性分析2004年1月至2013年12月间大连地区确诊的99例直肠神经内分泌肿瘤患者的临床病理和生存资料,生存分析采用Cox比例风险模型计算风险比值和95%可信区间。结果诊断直肠神经内分泌肿瘤常用的辅助检查有直肠镜、超声、CT和MRI,其阳性诊断率分别为100.0%、58.6%、49.5%和70.6%。常用的免疫组化指标有嗜铬蛋白A、突触囊泡蛋白和神经元特异性烯醇化酶,其阳性诊断率分别为74.7%、76.2%和32.7%。主要临床表现为便血的患者为36例(36.4%),为腹痛的患者22例(22.2%)。肿瘤平均直径为(7.2±3.2)cm,肿瘤直径以>2cm为主,占全部的75.8%。患者平均生存时间为(9.4±0.2)年,生存分析发现肿瘤直径是影响预后的独立因素,差异有统计学意义(P=0.03)。结论直肠神经内分泌肿瘤以非功能性神经内分泌肿瘤居多,且无典型临床症状和体征,原发肿瘤直径将影响患者预后。Objective To describe clinical,pathological and prognostic characteristics in patients with rectal neuroendocrine tumors. Methods Retrospectively analyze the clinical and pathological data from 99 patients who were diagnosed with rectal neuroendocrine tumors and treated at hospitals in Dalian between January 2004 and December 2013. Cox proportional hazard models were used to estimate hazard ratios and 95% confidence interval. Results Proctoscope,ultrasound,CT and MRI were commonly used auxiliary examination ways for the diagnosis of colorectal neuroendocrine tumors and the positive predictive value was100. 0%,58. 6%,49. 5% and 70. 6% respectively. Chromogranin protein A,synaptophysin and neuron-specific enolase were commonly used immunohistochemical indicators and the positive predictive value was74. 7%,76. 2% and 32. 7% respectively. Major clinical manifestations included hematochezia in 36 patients（ 36. 4%） and abdominal pain in 22 patients（ 22. 2%）. The mean tumor diameter was（ 7. 2 ± 3. 2） cm,primarily〉 2 cm,which make up 90% of the overall tumors. The mean overall survival was（ 9. 4 ± 0. 2）years. Multivariate analysis confirmed that tumor size were the independent prognostic factor（ P = 0. 03）.Conclusion Non-functional tumors account for most of the rectal neuroendocrine neoplasms and most cases did not have significant clinical symptoms. Tumor size has a significant influence on survival.

关 键 词：神经内分泌肿瘤 临床流行病学 预后分析 

分 类 号：R735.37[医药卫生—肿瘤]