本文選題：神經(jīng)內(nèi)分泌瘤 + 胃腸胰神經(jīng)內(nèi)分泌腫瘤��； 參考：《中華臨床醫(yī)師雜志(電子版)》2015年15期

【摘要】：目的探討112例胃腸胰神經(jīng)內(nèi)分泌腫瘤的臨床特點(diǎn)、病理特點(diǎn),以提高對(duì)該疾病的認(rèn)識(shí)及診治水平,減少誤診漏診。方法選取2009年1月至2014年1月山西省腫瘤醫(yī)院收治的經(jīng)手術(shù)病理確診的112例胃腸胰神經(jīng)內(nèi)分泌腫瘤患者的臨床資料,對(duì)其臨床表現(xiàn)、內(nèi)鏡、病理表現(xiàn)、診斷及治療等進(jìn)行回顧性分析。結(jié)果本組胃腸胰神經(jīng)內(nèi)分泌腫瘤112例,男91例,女21例,年齡在39~78歲,平均發(fā)病年齡(59.54±10.05)歲,發(fā)病部位最常見于胃,其次食管、直腸、結(jié)腸。主要癥狀為腹痛、腹脹、吞咽不暢,無(wú)1例出現(xiàn)類癌綜合征。免疫組化診斷嗜鉻顆粒蛋白A(Cg A)和突觸素(Syn)的陽(yáng)性率分別為71%、99%。這類腫瘤的轉(zhuǎn)移與病灶浸潤(rùn)深度相關(guān),當(dāng)浸潤(rùn)深度增加,轉(zhuǎn)移率也升高(P0.05)。組織學(xué)類型與腫瘤大小、周圍組織浸潤(rùn)深度、腫瘤標(biāo)記物CEA、CA242密切相關(guān)(χ2=37.958、12.987、8.898、6.524,均P0.05)。腫瘤TNM分期越高,腫瘤組織學(xué)類型分級(jí)越高(r=0.308,P=0.001);同時(shí)組織學(xué)類型分級(jí)越高,腫瘤標(biāo)記物異常越多。結(jié)論胃腸胰神經(jīng)內(nèi)分泌腫瘤是一種少見的疾病,臨床表現(xiàn)不典型,最常見的發(fā)生部位是胃,很多確診病例已經(jīng)是晚期。確診依靠病理檢查,Cg A、Syn的聯(lián)合檢測(cè)可協(xié)助診斷。胃腸胰神經(jīng)內(nèi)分泌腫瘤以手術(shù)治療為主。
[Abstract]:Objective to investigate the clinical and pathological features of 112 cases of gastrointestinal and pancreatic neuroendocrine tumors in order to improve the understanding, diagnosis and treatment of the disease and reduce misdiagnosis and missed diagnosis.Methods from January 2009 to January 2014, 112 patients with gastrointestinal and pancreatic neuroendocrine tumors admitted to Shanxi Provincial Cancer Hospital were selected. The clinical manifestations, endoscopy and pathological findings were analyzed.The diagnosis and treatment were analyzed retrospectively.Results 112 cases of gastrointestinal and pancreatic neuroendocrine neoplasms, 91 males and 21 females, were aged 3978 years. The average age of onset was 59.54 鹵10.05 years old. The most common site was the stomach, followed by esophagus, rectum and colon.The main symptoms were abdominal pain, abdominal distension, dysphagia and no carcinoid syndrome.The positive rates of A(Cg A and synaptophysin in immunohistochemical diagnosis were 71% and 99%, respectively.The metastasis of these tumors was correlated with the depth of invasion, and when the depth of invasion increased, the rate of metastasis also increased (P 0.05).Histological types were closely related to tumor size, depth of infiltration of surrounding tissues and tumor marker CEA CA242 (蠂 ~ 2 37. 958 ~ 12. 987 ~ 8. 898 ~ 6. 524, all P 0. 05).The higher the TNM stage was, the higher the histological grade was, and the higher the histological grade was, the more abnormal tumor markers were.Conclusion Gastrointestinal and pancreatic neuroendocrine tumor is a rare disease with atypical clinical manifestations and the most common site is the stomach.The diagnosis depends on the combined detection of C g A and Syn.Gastrointestinal and pancreatic neuroendocrine tumors are mainly treated by surgery.
【作者單位】： 山西醫(yī)科大學(xué)第二臨床醫(yī)學(xué)院消化內(nèi)科;
【分類號(hào)】：R735

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