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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2.	牛露伟, 刘浩, 王凯, 等. 胃肠道神经内分泌肿瘤 74 例临床分析. 中国普外基础与临床杂志, 2016, 23(4): 467-471.
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5.	梁建伟, 周志祥, 刘骞, 等. 不同亚型胃类癌的临床病理特征和预后因素分析. 中华肿瘤杂志, 2008, 30(11): 866-869.
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13.	陶曙, 桂林, 蒋鹏程. 27 例胃神经内分泌肿瘤的诊疗分析. 中国现代普通外科进展, 2015, 18(10): 815-817.
14.	刘丹, 沈琳, 陆明. 胃神经内分泌肿瘤的诊断和治疗. 临床肿瘤学杂志, 2015, (6): 549-554.
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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.
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22.	王霄, 宋争放, 姚文秀, 等. 胃肠胰神经内分泌瘤的临床病理特点及预后的多因素分析. 中华医学杂志, 2013, 93(18): 1411-1414.
23.	刘勇, 梁寒, 刘宁, 等. 胃类癌生物学行为及与预后关系的临床研究. 中华胃肠外科杂志, 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. 牛露伟, 刘浩, 王凯, 等. 胃肠道神经内分泌肿瘤 74 例临床分析. 中国普外基础与临床杂志, 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. 龚海燕, 戈伟, 蒋松松, 等. 70 例胃肠胰神经内分泌肿瘤的诊治分析. 中国普外基础与临床杂志, 2014, 21(9): 1145-1148.
5. 梁建伟, 周志祥, 刘骞, 等. 不同亚型胃类癌的临床病理特征和预后因素分析. 中华肿瘤杂志, 2008, 30(11): 866-869.
6. 梁文全, 高云鹤, 李佶阳, 等. 104 例胃神经内分泌肿瘤的临床病理特征及预后分析. 中华胃肠外科杂志, 2016, 19(4): 427-431.
7. 胡世超, 邓跃华, 李广鑫, 等. 胃神经内分泌肿瘤的诊断及治疗 (附 74 例临床分析). 山东医药, 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, 刘尚梅. 胃原发性神经内分泌肿瘤的临床病理特征. 中华肿瘤杂志, 2014, 36(7): 522-527.
10. 张启瑜. 钱礼腹部外科学. 北京: 人民卫生出版社, 2006: 270-271.
11. 曹晖, 赵文毅. 应该重视特殊类型的胃肿瘤. 中华胃肠外科杂志, 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, 蒋鹏程. 27 例胃神经内分泌肿瘤的诊疗分析. 中国现代普通外科进展, 2015, 18(10): 815-817.
14. 刘丹, 沈琳, 陆明. 胃神经内分泌肿瘤的诊断和治疗. 临床肿瘤学杂志, 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, 宋争放, 姚文秀, 等. 胃肠胰神经内分泌瘤的临床病理特点及预后的多因素分析. 中华医学杂志, 2013, 93(18): 1411-1414.
23. 刘勇, 梁寒, 刘宁, 等. 胃类癌生物学行为及与预后关系的临床研究. 中华胃肠外科杂志, 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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