摘要
目的探讨消化系统神经内分泌肿瘤（NEN）的诊断及治疗策略。方法回顾性分析2000年1月至2012年12月间大连医科大学附属第一医院收治的29例NEN患者的临床资料，依照新的WHO分类法对其治疗方式及预后进行重新评估。结果29例患者中男19例，女10例，平均年龄46．5岁。全部病例均无类癌综合征的临床表现。所有病例均行手术治疗，其中2例胃神经内分泌癌分别行根治性全胃切除和根治性远端胃切除；3例位于十二指肠，其中2例为神经内分泌癌、1例为神经内分泌瘤，均行胰十二指肠切除；2例小肠神经内分泌癌均行小肠部分切除术；3例位于阑尾，其中1例神经内分泌癌行根治性右半结肠切除，2例神经内分泌瘤行阑尾切除术；1例升结肠神经内分泌癌行根治性右半结肠切除术：18例位于直肠，其中4例神经内分泌癌行经腹直肠癌前切除术或腹会阴联合直肠癌根治术，14例神经内分泌瘤则予以经腹直肠前切除术、经肛局部切除术或内镜黏膜切除术。全组13例神经内分泌癌患者术后1年生存率为38．4％，3年生存率为7．7％；16例神经内分泌瘤患者术后5年生存率为8113％。结论消化系统NEN的临床表现无特异性，多位于直肠，手术治疗是有效的方法；神经内分泌癌预后较差，而神经内分泌瘤预后良好。
Objective To investigate the diagnosis and treatment of neuroendocrine neoplasm （NEN） in the digestive system. Methods Clinical data of 29 patients with NEN from January 2000 to December 2012 in The First Affiliated Hospital of Dalian Medical University were analyzed retrospectively and the prognosis was evaluated according to the new WHO classification. Results There were 19 males and 10 females and the average age was 46.5 years. All the patients had no clinical manifestations of carcinoid syndrome, and they all received surgical treatment. Two cases were gastric neuroendocrine carcinoma （NEC）, who received radical total gastrectomy and distal gastric resection respectively. Three cases had neoplasm in the duodenum, including 2 NEC and 1 neuroendocrine tumor （NET）, and they all underwent Whipple＇s procedure. Two cases were small intestine NEC, who received partial small intestine resection. Three cases had neoplasm in the appendix, including 1 NEC treated with right hemicolectomy and 2 NET with appendectomy. One case was ascending colon NEC, who received right hemicolectomy. Eighteen cases had neoplasm in the rectum, including 4 NEC treated with low anterior resection and abdominoperineal resection respectively, and 14 cases of NET underwent low anterior resection, local resection, and endoscopic resection respectively. The 1-and 3-year survival rates of 13 NEC cases were 38.4% and 7.7% respectively. The 5-year survival rate of 16 NET cases was 81.3%. Conclusions NEN of digestive system is located mainly in the rectum and the clinical symptom is unspecific. Radical resection of NEN is the preferred treatment. The prognosis of NEC is poor, and that of NET is better.
出处
《中华胃肠外科杂志》
CAS
CSCD
2013年第11期1084-1087,共4页
Chinese Journal of Gastrointestinal Surgery
关键词
神经内分泌肿瘤
消化系统
神经内分泌癌
神经内分泌瘤
外科手术
Neuroendocrine neoplasms, digestive system
Neuroendocrine carcinoma
Neuroendocrine tumour
Surgical procedures
