摘要
目的探讨胃肠道神经内分泌肿瘤(GINEN)的临床病理特点。方法选取46例经临床及病理明确诊断为胃肠道神经内分泌肿瘤的患者作为研究对象,对患者的临床资料进行回顾性分析。结果46例患者临床表现为非特异性消化道症状,因肿瘤原发部位不同而表现各异,主要表现为腹痛19例(41.3%)、排便习惯改变7例(15.2%)、吞咽困难1例(2.2%),其余19例(41.3%)患者无不适,因常规体检而发现肿瘤。所有患者均未出现发作性皮肤潮红、腹泻等类癌综合征临床表现。46例患者接受内镜、超声内镜(EUS)、CT、B超检查,其病灶检出率分别为97.7%、93.8%、53.3%、33.3%。以直肠最常见,其次为胃、十二指肠、阑尾、回肠、结肠。其中男性患者好发部位为直肠和胃,女性患者好发部位为直肠。神经内分泌瘤(NET)41例(89.1%),神经内分泌癌(NEC)4例(8.7%)、混合性腺神经内分泌癌(MANEC)1例(2.2%);其中G133例(71.7%),G28例(17.4%),G35例(10.9%);NET患者中,男25例,女16例。NEC患者中,男4例,女0例。MANEC患者中,男1例,女0例。接受外科手术治疗14例;接受内镜治疗32例,包括钳除1例、高频电切6例、内镜黏膜切除术(EMR)术15例、内镜黏膜下剥离术(ESD)术10例。3例患者行术后辅助化疗,方案主要为依托泊苷联合铂类药物。结论胃肠道神经内分泌肿瘤以直肠多发;病理分类以NET最常见;手术切除仍是目前首选治疗方式,随着内镜技术的发展与成熟,内镜治疗亦是安全、有效、经济的治疗措施。
Objective To discuss the clinicopathological characteristics of gastrointestinal neuroendocrine neoplasms(GINEN).Methods A total of 46 patients with gastrointestinal neuroendocrine neoplasms diagnosed clinically and pathologically were studied,and their clinical data was retrospectively analyzed.Results The clinical manifestations of 46 patients were nonspecific digestive tract symptoms,which varied according to the primary site of the tumors.The main manifestations were abdominal pain in 19 cases(41.3%),change of defecation habits in 7 cases(15.2%)and dysphagia in 1 case(2.2%).The remaining 19 cases(41.3%)had no discomfort.Tumors were found by routine physical examination.No clinical manifestations of paroxysmal skin-flushing,diarrhea and other carcinoid syndrome were found in all patients.46 patients were examined by endoscopy,endoscopic ultrasonography(EUS),CT and B-mode ultrasonography.The detection rates of lesions were 97.7%,93.8%,53.3%and 33.3%respectively.Rectum was the most common,followed by stomach,duodenum,appendix,ileum and colon.The predilection sites of male patients were rectum and stomach,while those of female patients were rectum.There were 41 cases(89.1%)of neuroendocrine tumors(NET),4 cases(8.7%)of neuroendocrine carcinomas(NEC)and 1 case(2.2%)of mixed adenoneuroendocrine carcinoma(MANEC),of which G1 in 33 cases(71.7%),G2 in 8 cases(17.4%)and G3 in 5 cases(10.9%).There were 25 males and 16 females in NET patients,4 males and 0 female in NEC patients,1 male and 1 female in MANEC patients.Surgical treatment was performed in 14 cases,endoscopic treatment in 32 cases,including forceps removal in 1 case,high frequency electrotomy in 6 cases,endoscopic mucosal resection(EMR)in 15 cases,and endoscopic submucosal dissection(ESD)in 10 cases.3 patients underwent adjuvant chemotherapy,which was mainly etoposide combined with platinum drugs.3 patients underwent adjuvant chemotherapy,which was mainly etoposide combined with platinum drugs.Conclusion Neuroendocrine tumors of gastrointestinal tract occur fre
作者
廖惠娜
李曦
邹兵
LIAO Hui-na;LI Xi;ZOU Bing(Digestive System Department,Medical College of Shantou University,Shantou 515031,China)
出处
《中国实用医药》
2019年第28期14-16,共3页
China Practical Medicine
关键词
神经内分泌肿瘤
胃肠道
病理特点
Neuroendocrine tumors
Gastrointestinal
Pathological characteristics
