胃肠胰神经内分泌肿瘤的诊治分析  

The Analysis of the Diagnosis and Treatment of Gastroenteropancreatic Neuroendocrine Tumors

作　　者：刘万鲁[1] 李永柏 丁杰[1] 王润华[1] LIU Wanglu;LI Yongbai;DING Jie;WANG Runhua(Guizhou Provincial People's Hospital,Guiyang 550002,China)

机构地区：[1]贵州省人民医院

出　　处：《贵阳中医学院学报》2019年第6期31-37,共7页Journal of Guiyang University of Chinese Medicine

基　　金：贵州省高层次留学人才创新创业项目,项目编号:留学人才择优资助合同(2018)04号

摘　　要：目的:分析胃肠胰神经内分泌肿瘤的发生部位、临床症状、病理特点、诊断、治疗及预后。方法:回顾性分析2002年4月到2018年4月经贵州省人民医院病理科病理学与免疫组化确诊为GEP-NETs患者的临床病理资料。结果:男性居多(男女比例为1.25:1),平均年龄61.6岁。234例患者中,最常见的发病部位是胃78例(33.3%),其他依次为直肠46例(19.7%)、胰腺35例(15.0%)、结肠27例(11.5%)、肝脏23例(9.8%)、空回肠10例(4.3%)、食管6例(2.6%)、十二指肠5例(2.1%)、阑尾3例(1.3%)、胆囊1例(0.4%),其中只有3例(1.3%)表现出类癌综合征。138例(59.0%)为局部病变,区域性转移的76例(32.5%)和20例(8.5%)发生远处转移,大部分转移至肝,其他转移部位包括盆腔、肺、脑等,胃和结肠NETs常见的是区域转移,胰腺和肝脏NETs大多发生远处转移。结论:胃肠道和胰腺神经内分泌肿瘤并不罕见。近几年来胃肠道和胰腺神经内分泌肿瘤的发病率和部位已发生了明显的改变。胃是胃肠道神经内分泌肿瘤的最常见的部位,其次是直肠和胰腺。Objective:To explore the occurrence sites,clinical manifestations,pathologic characteristics,diagnosis,treatment and prognosis of gastroenteropancreatic neuroendocrine tumors(GEP-NET). Methods:From April 2002 to April 2018,clinical pathological datas of GEP-NET patients in the Guizhou Provincial People’s Hospital were retrospectively analyzed.The neuroendocrine diagnosis of the tumors were determined by pathology and immunohistochemistry.Results:The results showed a male preponderance(ratio of 1.25:1) with a mean age of 61.6 years. Of the 234 tumors patients,the commonest site was found to be stomach 78(33.3%),followed by rectum 46(19.7%),pancreas 35(15.0%),colon 27(11.5%),hepar 23(9.8%) small intestine 10(4.3%),esophagus 6(2.6%),duodenum 5(2.1%),appendix 3(1.3%),and gallbladder 1(0.4%).Only 3(1.3%) patients presented with carcinoid syndrome. The disease was localized in 138(59.0%),regional spread and distant spread observed in 76(32.5%) and 20(8.5%)patients, respectively. Majority of gastric and colonic tumors had localized disease while pancreatic and hepatic NETs led to most of the cases with distant disease.Conclusion:This analysis showed that gastrointestinal and rectum neuroendocrine tumors are not rare. Pattern of these tumors has definitely changed over last few years.Stomach was found to be commonest site for gastrointestinal neuroendocrine tumors followed by rectum and pancreas.

关 键 词：胃肠道 神经内分泌肿瘤 类癌综合征 病理特点 

分 类 号：R735[医药卫生—肿瘤]