36例小肠神经内分泌肿瘤的临床病理特征及预后分析  

Analysis of clinicopathological features and prognosis of 36 patients with small intestinal neuroendocrine neoplasms

作　　者：花威 宋晨源 徐刚 Hua Wei;Song Chenyuan;Xu Gang(Department of Gastroenterology,He nan Provincial Chest Hospital Zhengzhou University,Zhengzhou,450000,China)

机构地区：[1]河南省胸科医院郑州大学附属胸科医院消化内科,郑州450000 [2]郑州市第一人民医院消化内科

出　　处：《临床内科杂志》2025年第3期217-220,共4页Journal of Clinical Internal Medicine

摘　　要：目的 探讨小肠神经内分泌肿瘤(SI-NENs)的临床病理特征,并进行预后因素分析。方法 回顾性纳入SI-NENs患者36例,根据发病部位不同分为非壶腹部组18例、壶腹部组12例、空/回肠组6例。收集所有患者的一般临床资料及5年生存率并进行组间比较。采用Log-Rank单因素分析评估患者5年生存率的影响因素;采用Cox多因素回归分析评估患者5年生存率的危险因素。结果 空/回肠组肿瘤直径≥2 cm、T3~T4、N1、Ⅲ~Ⅳ期患者比例较高(P<0.05)。壶腹部组G3级、T3~T4、N1及Ⅲ~Ⅳ期患者比例均高于非壶腹部组(P<0.05)。患者中位随访时间为33.5个月,随访期间9例患者死亡,非壶腹部NENs、壶腹部NENs、空/回肠NENs患者5年生存率分别为90.9%、59.4%、33.3%(P<0.05)。单因素Log-Rank分析结果发现,肿瘤部位、肿瘤直径、TNM分期、病理分级均与患者5年生存率相关;多因素Cox分析结果显示,肿瘤部位(空/回肠)、TNM分期(Ⅲ~Ⅳ期)是影响患者5年生存率的独立危险因素(P<0.05)。结论 SI-NENs的发病率低,不同病理学特征影响患者预后;空/回肠NENs、TNM分期为Ⅲ~Ⅳ期提示患者预后较差。Objective To investigate the clinicopathological features and prognostic factors of small intestinal neuroendocrine neoplasms(SI-NENs).Methods 36 patients with SI-NENs were retrospectively included,and divided into non-ampulla group(18 cases),ampulla group(12 cases),and empty/ileum group(6 cases)according to different sites of disease.General clinical data and 5-year survival rate of all patients were collected and compared between groups.The factors affecting the 5-year survival rate were evaluated by Log-Rank univariate analysis.The risk factors influencing the 5-year survival rate were analyzed by Cox multivariate regression analysis.Results The proportions of patients with tumor diameter≥2 cm,T3~T4,N1,II~IV were higher in empty/ileum group(P<0.05).The proportions of G3,T3~T4,N1 and II~IV patients in ampulla group were higher than those in non-ampulla group(P<0.05).The median follow-up time was 33.5 months,during which 9 patients died.The 5-year survival rates of non-ampulla NENs,ampulla NENs,and empty/ileal NENs were 90.9%,59.4%and 33.3%,respectively(P<0.05).Single-factor analysis at Log-Rank showed that tumor site,tumor diameter,TNM stage,and pathological grade were correlated with 5-year survival.Multivariate analysis Cox showed that tumor site(empty/ileum)and TNM stage(II to IV stages)were independent risk factors for 5-year survival(P<0.05).Conclusion SI-NENs are characterized by low incidence,Different pathological grades of SI-NENs have different prognosis.jejunal/ileal NEN and stage II~IV mostly indicate poor prognosis of patients.

关 键 词：小肠 神经内分泌肿瘤 临床病理特征 预后 

分 类 号：R735.3[医药卫生—肿瘤]