【摘要】：目的胃腸道神經(jīng)內(nèi)分泌腫瘤(gastrointestinal neuroendocrine neoplasm,GI-NEN)較常見,近年來其發(fā)病率明顯上升。本研究回顧性分析GI-NEN患者的臨床特征,并探討影響其預后的相關因素。方法分析2007-02-01-2013-02-28四川省人民醫(yī)院收治的109例GI-NEN患者的臨床特征及隨訪資料,采用Cox回歸模型探討影響患者預后的相關因素。結果 109例GI-NEN患者中,胃部神經(jīng)內(nèi)分泌腫瘤49例(44.95%),腸部神經(jīng)內(nèi)分泌腫瘤60例(55.05%)。淋巴結轉移患者38例(34.86%),遠處轉移患者18例(16.51%)。患者臨床表現(xiàn)均無功能性,主要表現(xiàn)為消化道非特異性癥狀或腫瘤局部占位癥狀。隨訪中位生存期為30個月,1、3、5年生存率分別為77.98%(85/109)、54.13%(59/109)和40.37%(44/109)。單因素分析顯示,不同腫瘤大小、病理分類、病理分級和是否伴有遠處轉移的GI-NEN患者之間生存率差異有統(tǒng)計學意義,P0.05。多元Cox回歸分析顯示,病理分級G2(HR=1.54,95%CI:1.04~2.29)和G3(HR=3.67,95%CI:1.85~7.31)(均相較于病理分級G1),以及伴遠處轉移(HR=2.02,95%CI:1.02~3.98)是GI-NEN患者預后的危險因素。結論 GI-NEN患者臨床表現(xiàn)無特異性,伴遠處轉移和病理分級較晚是GI-NEN患者的預后獨立危險因素。
[Abstract]:Objective Gastrointestinal neuroendocrine neoplasms (gastrointestinal neuroendocrine neoplasm,GI-NEN) are more common and their incidence has increased significantly in recent years. This study retrospectively analyzed the clinical features of patients with GI-NEN, and explored the prognostic factors. Methods the clinical features and follow-up data of 109 patients with GI-NEN admitted to Sichuan Provincial people's Hospital from January to January, 2007 were analyzed. The factors related to the prognosis of the patients were investigated by Cox regression model. Results there were 49 cases (44.95%) of gastric neuroendocrine tumors and 60 cases (55.05%) of intestinal neuroendocrine tumors. There were 38 cases (34.86%) with lymph node metastasis and 18 cases (16.51%) with distant metastasis. The clinical manifestations of the patients were nonfunctional, mainly characterized by non-specific gastrointestinal symptoms or local tumor occupying symptoms. The median survival time was 30 months, and the survival rates were 77.98% (85 / 109), 54.13% (59 / 109) and 40.37% (44 / 109), respectively. Univariate analysis showed that there were significant differences in survival rate among GI-NEN patients with different tumor size, pathological classification, pathological grade and distant metastasis (P0.05). Multiple Cox regression analysis showed that pathological grade G2 (HR=1.54,95%CI:1.04~2.29), G3 (HR=3.67,95%CI:1.85~7.31) (compared with pathological grade G1) and distant metastasis (HR=2.02,95%CI:1.02~3.98) were risk factors for prognosis of GI-NEN patients. Conclusion there is no specificity in clinical manifestations of GI-NEN patients. Distant metastasis and late pathological grading are independent prognostic risk factors in GI-NEN patients.
【作者單位】： 四川省醫(yī)學科學院·四川省人民醫(yī)院胃腸外科;
【分類號】：R735
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本文編號：2276711