86例胃神经内分泌癌的临床病理特征及预后相关性分析  

Clinicopathological Features and Prognostic Factors with Gastric Neuroendocine Cancer

作　　者：郑艳[1] 黄俊鹏 陈小岩[2] 刘振华[1] ZHENG Yan;HUANG Junpeng;CHEN Xiaoyan;LIU Zhenhua(Department of Oncology,Fujian Provincial Hospital,Fuzhou 350000,China;Department of Pathology,Fujian Provincial Hospital,Fuzhou 350000,China)

机构地区：[1]福建省立医院肿瘤内科,福建福州350000 [2]福建省立医院病理科,福建福州350000

出　　处：《中国医药指南》2021年第32期45-47,51,共4页Guide of China Medicine

摘　　要：目的回顾分析胃神经内分泌癌的临床病理特征及预后相关因素,建立该疾病预后预测模型,为临床诊治工作提供一些依据。方法回顾收集2012年6月至2020年1月我院收治的共86例术后病理确诊为G-NEC的患者的病理特征、术后辅助化疗、血指标等,采用log-rank进行统计学检验,利用COX比例风险模型回顾性分析了这些特征对G-NEC患者预后的影响。采用Kaplan-Meier法绘制生存曲线,绘制nomogram(列线图)制作G-NEC预后预测模型。C指数评价该模型的预测能力。结果COX单因素回归分析示肿瘤分期、脉管及神经是否侵犯、术前NLR具有统计学意义(P<0.05)。COX多因素回归分析显示神经侵犯、肿瘤分期是G-NEC预后独立预测因子(P<0.05)。Nomogram模型C-index指数为0.829。结论临床病理分期(Ⅰ~Ⅳ期)、脉管及神经是否受累、NLR、术后辅助与预后相关。肿瘤侵犯浆膜、淋巴结转移大于3个、远处转移、神经受累是G-NEC预后差的独立预测因子,建立的Nomogram列线图显示预测模型为中等准确。Objective The clinicopathological characteristics and prognostic factors of gastric neuroendocrine carcinoma were retrospectively analyzed,and the prognosis prediction model of the disease was established to provide some basis for clinical diagnosis and treatment.Methods The clinical data of86 patients who were diagnosed with G-NEC pathologically after surgery and were admitted to Fujian Provincial Hospital from June 2012 to January 2020 were collected,including pathological data,postoperative adjuvant chemotherapy,blood remark et al.The COX proportional hazards model was used to retrospectively analyze the effects of these characteristics on the prognosis of G-NEC patients.Kaplan-Meier method was used to draw survival curve,Log-rank was used for statistical test,and nomogram was used to make G-NEC prognostic prediction model.The C index evaluated the predictive ability of the model.Results COX univariate regression analysis showed that tumor stage,vessel and nerve invasion,and preoperative NLR were statistically significant(P<0.05).COX multivariate regression analysis showed that nerve invasion and tumor stage were independent predictors of G-NEC prognosis(P<0.05).The C-index results of the Nomogram model is 0.829.Conclusion Clinicopathological stage(Ⅰ-Ⅳ),vessel and nerve involvement,NLR,and postoperative assistance were all related to the prognosis.Tumor invasion of the serosal membrane,lymph node metastasis more than 3,distant metastasis,and nerve involvement are independent predictors of poor prognosis of G-NEC.The Nomogram prediction model ismedium predictive ability.

关 键 词：胃神经内分泌癌 肿瘤分期 病理特征 NLR 列线图 

分 类 号：R735.2[医药卫生—肿瘤]