Clinicopathological features and prognosis of 44 patients with gastric neuroendocrine neoplasms_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Yafei , SONG Jun , LIANG Yong , SONG Hu , XU Yixin , XU Teng , FAN Ruizhi ,  XU Wei

Department of Gastrointestinal Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, P.R.China;

Corresponding?author：

XU Wei, Email: eryuanxuwei@126.com

Keywords：

gastric neuroendocrine neoplasms; clinicopathological features; treatment; prognosis

DOI：

10.7507/1007-9424.201607072

Video：

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Objective To investigate the clinical features, treatment, and influence factors of prognosis in patients with gastric neuroendocrine neoplasms (GNENs). Methods From March 2011 to January 2016, the clinicopathological data of 44 patients with GNENs who treated in The Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed to summarize the choice of treatment plan and analyze influence factors of prognosis. Results A total of 44 patients enrolled in this study. The major clinical manifestation included abdominal pain in 18 patients (40.9%), abdominal distension in 16 patients (36.4%), loss of appetite in 4 patients (9.1%), acid regurgitation and belching in 4 patients (9.1%), nausea and vomiting in 1 patient (2.3%), eating after choking sense in 3 patients (6.8%), gastrointestinal bleeding in 2 patients (4.5%), diarrhea in 1 patient (2.3%), and palpitations with weakness in 3 patients (6.8%). The treatment of 44 patients included radical resection in 26 patients (59.1%), endoscopic resection in 13 patients (29.6%), local excision in 1 patient (2.3%), and 4 patients had distant metastasis before operation were conducted of palliative treatment〔palliative resection in 2 patients (4.5%) and conservative treatment in 2 patients (4.5%)〕. Univariate analysis showed that the gender, the age, the tumor size, and the N staging (lymph node metastasis) were not associated with prognosis (P>0.050), but the tumor location and the depth of tumor invasion were related to the prognosis (P<0.050). The tumors located in the upper part of the stomach and the serosal infiltration indicated poor prognosis. However, neither of them can be used as independent factor to evaluate the poor prognosis of GNENs patients (P>0.050). Conclusions GNENs has nonspecific clinical manifestation. Radical surgery and endoscopic resection are the main treatment methods, but the influence factors of prognosis in GNENs patients need further study.

Citation： ZHANG Yafei, SONG Jun, LIANG Yong, SONG Hu, XU Yixin, XU Teng, FAN Ruizhi, XU Wei. Clinicopathological features and prognosis of 44 patients with gastric neuroendocrine neoplasms. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(3): 349-354. doi: 10.7507/1007-9424.201607072 Copy

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13.	陶曙, 桂林, 蔣鵬程. 27 例胃神經內分泌腫瘤的診療分析. 中國現代普通外科進展, 2015, 18(10): 815-817.
14.	劉丹, 沈琳, 陸明. 胃神經內分泌腫瘤的診斷和治療. 臨床腫瘤學雜志, 2015, (6): 549-554.
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18.	Kulke MH, Anthony LB, Bushnell DL,et al. NANETS treatment guidelines: well-differentiated neuroendocrine tumors of the stomach and pancreas. Pancreas, 2010, 39(6): 735-752.
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23.	劉勇, 梁寒, 劉寧, 等. 胃類癌生物學行為及與預后關系的臨床研究. 中華胃腸外科雜志, 2007, 10(5): 472-475.
24.	Chiba N, Suwa T, Hori M,et al. Advanced gastric endocrine cell carcinoma with distant lymph node metastasis: a case report and clinicopathological characteristics of the disease. Gastric Cancer, 2004, 7(2): 122-127.
25.	Kubota T, Ohyama S, Hiki N,et al. Endocrine carcinoma of the stomach: clinicopathological analysis of 27 surgically treated cases in a single institute. Gastric Cancer, 2012, 15(3): 323-330.

1. ?Modlin IM, Latich I, Kidd M,et al. Therapeutic options for gastrointestinal carcinoids. Clin Gastroenterol Hepatol, 2006, 4(5): 526-547.
2. 牛露偉, 劉浩, 王凱, 等. 胃腸道神經內分泌腫瘤 74 例臨床分析. 中國普外基礎與臨床雜志, 2016, 23(4): 467-471.
3. Modlin IM, Kidd M, Latich I,et al. Current status of gastrointestinal carcinoids. Gastroenterology, 2005, 128(6): 1717-1751.
4. 龔海燕, 戈偉, 蔣松松, 等. 70 例胃腸胰神經內分泌腫瘤的診治分析. 中國普外基礎與臨床雜志, 2014, 21(9): 1145-1148.
5. 梁建偉, 周志祥, 劉騫, 等. 不同亞型胃類癌的臨床病理特征和預后因素分析. 中華腫瘤雜志, 2008, 30(11): 866-869.
6. 梁文全, 高云鶴, 李佶陽, 等. 104 例胃神經內分泌腫瘤的臨床病理特征及預后分析. 中華胃腸外科雜志, 2016, 19(4): 427-431.
7. 胡世超, 鄧躍華, 李廣鑫, 等. 胃神經內分泌腫瘤的診斷及治療 (附 74 例臨床分析). 山東醫藥, 2014, 54(5): 58-59.
8. Yao JC, Hassan M, Phan A,et al. One hundred years after ‘carcinoid’: epidemiology of and prognostic factors for neuroendocrine tumors in 35 825 cases in the United States. J Clin Oncol, 2008, 26(18): 3063-3072.
9. 梁晶, 劉尚梅. 胃原發性神經內分泌腫瘤的臨床病理特征. 中華腫瘤雜志, 2014, 36(7): 522-527.
10. 張啟瑜. 錢禮腹部外科學. 北京: 人民衛生出版社, 2006: 270-271.
11. 曹暉, 趙文毅. 應該重視特殊類型的胃腫瘤. 中華胃腸外科雜志, 2013, 16(2): 128-131.
12. Ardill JE, Erikkson B. The importance of the measurement of circulating markers in patients with neuroendocrine tumours of the pancreas and gut. Endocr Relat Cancer, 2003, 10(4): 459-462.
13. 陶曙, 桂林, 蔣鵬程. 27 例胃神經內分泌腫瘤的診療分析. 中國現代普通外科進展, 2015, 18(10): 815-817.
14. 劉丹, 沈琳, 陸明. 胃神經內分泌腫瘤的診斷和治療. 臨床腫瘤學雜志, 2015, (6): 549-554.
15. Basuroy R, Srirajaskanthan R, Prachalias A,et al. Review article: the investigation and management of gastric neuroendocrine tumours. Aliment Pharmacol Ther, 2014, 39(10): 1071-1084.
16. Lawrence B, Gustafsson BI, Chan A,et al. The epidemiology of gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am, 2011, 40(1): 1-18.
17. Ichikawa J, Tanabe S, Koizumi W,et al. Endoscopic mucosal resection in the management of gastric carcinoid tumors. Endoscopy, 2003, 35(3): 203-206.
18. Kulke MH, Anthony LB, Bushnell DL,et al. NANETS treatment guidelines: well-differentiated neuroendocrine tumors of the stomach and pancreas. Pancreas, 2010, 39(6): 735-752.
19. Schwarz RE, Fuller RA, Chu P. Unusual presentations of uncommon tumors: case 2. Gastric carcinoid metastatic to the liver. J Clin Oncol, 2002, 20(9): 2403-2404.
20. Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer, 2003, 97(4): 934-959.
21. Maggard MA, O’Connell JB, Ko CY. Updated population-based review of carcinoid tumors. Ann Surg, 2004, 240(1): 117-122.
22. 王霄, 宋爭放, 姚文秀, 等. 胃腸胰神經內分泌瘤的臨床病理特點及預后的多因素分析. 中華醫學雜志, 2013, 93(18): 1411-1414.
23. 劉勇, 梁寒, 劉寧, 等. 胃類癌生物學行為及與預后關系的臨床研究. 中華胃腸外科雜志, 2007, 10(5): 472-475.
24. Chiba N, Suwa T, Hori M,et al. Advanced gastric endocrine cell carcinoma with distant lymph node metastasis: a case report and clinicopathological characteristics of the disease. Gastric Cancer, 2004, 7(2): 122-127.
25. Kubota T, Ohyama S, Hiki N,et al. Endocrine carcinoma of the stomach: clinicopathological analysis of 27 surgically treated cases in a single institute. Gastric Cancer, 2012, 15(3): 323-330.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinicopathological features and prognosis of 44 patients with gastric neuroendocrine neoplasms

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