Clinical and pathological characteristics and prognosis of 132 cases of rectal neuroendocrine tumors

被引:17
作者
Yu, Yong-Jun [1 ]
Li, Yu-Wei [1 ]
Shi, Yang [1 ]
Zhang, Zhao [1 ]
Zheng, Min-Ying [2 ]
Zhang, Shi-Wu [2 ]
机构
[1] Tianjin Union Med Ctr, Dept Colorectal Surg, Tianjin 300121, Peoples R China
[2] Tianjin Union Med Ctr, Dept Pathol, Jieyuan Rd, Tianjin 300121, Peoples R China
关键词
Neuroendocrine tumors; Prognosis; Univariate analysis; Tumor size; Tumor grade; Neuroendocrine carcinoma; SURGICAL-TREATMENT; COLON; DIAGNOSIS; RESECTION; CANCER; GUIDELINES; CARCINOMA;
D O I
10.4251/wjgo.v12.i8.893
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND Neuroendocrine tumors (NETs) frequently occur in the gastrointestinal tract, lung, and pancreas, and the rectum and appendix are the sites with the highest incidence. Epidemiology statistics show that an estimated 8000 people every year in the United States are diagnosed with NETs occurring in the gastrointestinal tract, including the stomach, intestine, appendix, colon, and rectum. The pathological changes and clinical symptoms of NETs are not specific, and therefore they are frequently misdiagnosed. AIM To investigate the clinical symptoms, pathological characteristics, treatment, and prognosis of rectal neuroendocrine tumors (RNETs) by analyzing the clinical and pathological data of 132 RNET cases at our hospital. METHODS All RNETs were graded according to Ki-67 positivity and mitotic events. The tumors were staged as clinical stages I, II, III, and IV according to infiltrative depth and tumor size. COX proportional hazard model was used to assess the main risk factors for survival. RESULTS These 132 RNETs included 83 cases of G1, 21 cases of G2, and 28 cases of G3 (neuroendocrine carcinoma) disease. Immunohistochemical staining showed that 89.4% of RNETs were positive for synaptophysin and 39.4% positive for chromogranin A. There were 19, 85, 23, and 5 cases of clinical stages I, II, III, and IV, respectively. The median patient age was 52.96 years. The diameter of tumor, depth of invasion, and pathological grade were the main reference factors for the treatment of RNETs. The survival rates at 6, 12, 36, and 60 mo after operation were 98.5%, 94.6%, 90.2%, and 85.6%, respectively. Gender, tumor size, tumor grade, lymph node or distant organ metastasis, and radical resection were the main factors associated with prognosis of RNETs. Multivariate analysis showed that tumor size and grade were independent prognostic factors. CONCLUSION The clinical symptoms of RNETs are not specific, and they are easy to misdiagnose. Surgery is the main treatment method. The grade and stage of RNETs are the main indices to evaluate prognosis.
引用
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页码:893 / 902
页数:10
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