胃神经内分泌肿瘤50例临床病理特征分析  

Clinical and pathologic characteristics of 50 patients with gastric neuroendocrine neoplasms

作　　者：侯雯雯[1] 唐彤宇[1] 王京[1] 马坦坦[1] 曹婷婷[1] 李福冬 徐红[1] 

机构地区：[1]吉林大学白求恩第一医院胃肠内科,长春130021

出　　处：《中华消化内镜杂志》2017年第7期502-505,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨胃神经内分泌肿瘤（g-NENs）的临床表现、病理特点。方法2012年5月至2016年1月，吉林大学白求恩第一医院病理确诊的50例g-NENs病例纳入回顾性分析，总结临床表现和病理特点，并比较其中瘤与癌的病变部位、大体形态、最大径、淋巴结转移率、远处转移率及患者生存期。结果男34例、女16例，男女比例2．125：1。年龄33—77岁，平均（60±11）岁。神经内分泌瘤13例（26％），神经内分泌癌31例（62％），混合型腺神经内分泌癌6例（12％）。病变最大径〈2cm者8例（16％），≥2cm者42例（84％）。病变单发48例（96％），多发2例（4％）。病变位于胃窦19例（38％），胃体16例（32％），贲门、胃底11例（22％），胃角3例（6％），胃体窦交界1例（2％）。32例（64％）发生转移，淋巴结转移20例、远处转移12例。患者临床症状不一，主要为消化系统症状和肿瘤占位症状，无一例出现类癌综合征。13例瘤与37例癌对比分析后发现，两者在病变大体形态（χ^2=24．446，P=0．000）、病变最大径（t=-4．044，P=0．001）、淋巴结转移率（χ^2=4．435，P=0．035）、患者生存期（t=2．925，P=0．000）方面差异均有统计学意义，在病变部位（r=6．921，P=0．082）、远处转移率（χ^2=0．715，P=0．389）方面差异均无统计学意义。结论g-NENs可发生于胃内任何部位，多为单发，患者临床症状无特异性。其中，胃神经内分泌癌和混合型腺神经内分泌癌大体类型多为溃疡型，病变直径大，患者预后差。Objective To investigate the clinical and pathologic features of patients with gastric neuroendocrine neoplasms （g-NENs）. Methods A total of 50 cases of g-NENs diagnosed by pathology in the First Hospital of Jilin University from May 2012 to January 2016 were retrospective analyzed to summarize the clinical manifestations and pathological features. The location of lesion, gross morphology, maximum diameter, lymph node metastasis rate, distant metastasis rate, and survival time between patients with neuroendocrine tumors and neuroendocrine carcinomas were compared. Results Among the 50 patients, 34 were males and 16 were females with a male to female ratio of 2. 125 ： 1. Their age ranged from 33 to 77 years with an mean age of 60± 11 years. There were 13 cases （ 26% ） of neuroendocrine tumors, 31 （ 62% ） neuroendocrine carcinomas, and 6 （12%） mixed adenoneuroendocrine carcinomas. The maximum diameter of lesion was less than 2 cm in 8 cases （16%） , and equal or greater than 2 cm in 42 cases （84%）. There was single lesion in 48 cases （96%） and multiple lesions in 2 cases （4%）. There were 19 cases （38%） located in gastric antrum, 16 （32%） in gastric body,11 （22%） in gastric fundus or cardia, 3 （6%） in gastric angle, and 1 （2%） in the junction of gastric antrum and body. Thirty-two patients （64%） had metastasis, including 20 cases of lymph node metastasis and 12 cases of distant metastasis. The clinical symptoms of the patients were different, mainly were digestive system symptoms and tumor occupying symptoms, and no carcinoid syndrome was reported. The gross morphology （χ^2 = 24. 446, P= 0. 000）, maximum diameter （ t = -4. 044, P= 0. 001 ）, lymph node metastasis rate （χ^2 =4. 435, P=0. 035）, and survival time （t=2. 925, P=0. 000） were significantly differences between 13 cases of neuroendocrine tumors and 37 cases of neuroendocrine carcinoma. But the location of lesion （χ^2= 6. 921, P=0. 082） and distant metastasis rate （χ^2= 0. 715,

关 键 词：神经内分泌瘤 胃肿瘤 病理学 临床 免疫组织化学 

分 类 号：R735.2[医药卫生—肿瘤]