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Ⅳ型胃神经内分泌肿瘤的临床病理特征及影响术后复发的危险因素分析

  

  1. 河北医科大学第四医院 消化内科,河北 石家庄 050000
  • 出版日期:2020-09-20 发布日期:2020-07-09
  • 通讯作者: 张瑞星,Email:zrx@medmail.com.cn

Clinicopathological characteristics of type Ⅳ G-NENs and analysis of risk factors affecting postoperative recurrence

  1. Department of Gastroenterology, the Fourth Hospital of Hebei Medical University,  Shijiazhuang 050000,  China
  • Online:2020-09-20 Published:2020-07-09
  • Contact: Corresponding author:Zhang Ruixing,Email:zrx@medmail.com.cn

摘要: 目的  探索Ⅳ型胃神经内分泌肿瘤(GNENs)的临床病理特征及影响术后复发的危险因素。方法  根据2010年世界卫生组织提出的GNENs病理分级标准,将69例Ⅳ型GNENs患者分为胃神经内分泌癌组(GNEC)、胃混合性腺神经内分泌癌组(GMANEC)。分析其临床病理特征及影响术后复发的危险因素。结果  Ⅳ型GNENs以中老年男性多见,首诊症状不典型。GNEC与GMANEC的临床病理特征差异无统计学意义(P>0.05)。GMANEC组较GNEC组术后不易复发,行辅助化疗的患者预后均较未化疗者好。Ⅳ型GNENs、GMANEC患者使用依托泊苷+顺铂(EP)方案或奥沙利铂+替吉奥(SOX)方案行辅助化疗对术后复发的影响无统计学意义(P>0.05)。结论  Ⅳ型GNENs患者的临床表现不典型。GNEC与GMANEC的临床病理特征相似。GMANEC患者较GNEC患者预后好,辅助化疗可以改善Ⅳ型GNENs患者的预后,使用EP或SOX方案行辅助化疗对Ⅳ型GNENs、GMANEC患者预后的影响无明显差异。

关键词: 胃肿瘤, 神经内分泌瘤, 复发

Abstract: Objective  To explore the clinicopathological characteristics and the risk factors in postoperative recurrence of type Ⅳ GNENs. Methods  According to  GNENs pathological grading standard proposed by  World Health Organization in 2010, 69 patients with type Ⅳ GNENs were divided into GNEC group and GMANEC group. The clinicopathological characteristics and risk factors affecting postoperative recurrence of these two groups were analyzed. Results  Type Ⅳ GNENs were more common in middleaged and old men, and the symptoms at the first diagnosis were not typical. There was no statistically significant difference in the clinicopathological characteristics between GNEC and GMANEC group (P>0.05). GMANEC group was less prone to recurrence after operation than GNEC group, and the patients with adjuvant chemotherapy had better prognosis than those without chemotherapy. In patients with type Ⅳ GNENs and GMANEC, the use of EP regimen or SOX regimen for adjuvant chemotherapy had no statistically significant effect on postoperative recurrence (P>0.05). Conclusion  The clinical manifestations of patients with type Ⅳ GNENs are not typical. The clinicopathological characteristics of GNEC and GMANEC are similar. GMANEC patients have better prognosis than GNEC patients. Adjuvant chemotherapy can improve the prognosis of patients with type Ⅳ GNENs. The effects of adjuvant chemotherapy using EP or SOX regimen have no significant difference in the prognosis of patients with type Ⅳ GNENs and GMANEC.

Key words: stomach neoplasms, neuroendocrine tumors, recurrence