中国实用外科杂志

中国实用外科杂志 ›› 2023, Vol. 43 ›› Issue (05): 572-577.DOI: 10.19538/j.cjps.issn1005-2208.2023.05.18

• 论著 • 上一篇    下一篇

胃肠神经内分泌肿瘤174例临床病理学特征及预后分析#br#

左冰玉，孙    晶，臧    潞   

  1. 上海交通大学医学院附属瑞金医院普外科    上海市微创外科临床医学中心，上海200025
  • 出版日期:2023-05-01 发布日期:2023-05-29

  • Online:2023-05-01 Published:2023-05-29

摘要： 目的    分析原发性胃肠神经内分泌肿瘤（GI-NEN）的临床病理学特征、治疗效果及生存预后。方法    回顾性分析 2015 年 1 月至 2020 年 12 月上海交通大学医学院附属瑞金医院收治的174例GI-NEN病例的临床资料，其中胃神经内分泌肿瘤（NEN）35例，肠NEN 139例。应用 Kaplan-Meier法绘制生存曲线，采用 Log-rank检验比较胃、肠高级别NEN两组5年总生存率与3年无进展生存率，并分析辅助化疗对高级别NEN病人预后的影响。 结果    174例GI-NEN病例中，胃高级别NEN 23例，肠高级别NEN 13例；胃低级别NEN 12例，肠低级别NEN 126例。低级别NEN生存率优于高级别NEN（P<0.01）；胃高级别NEN与肠高级别NEN的总生存率与无进展生存率差异无统计学意义（P＞0.05）；是否接受辅助化疗对胃、肠高级别NEN的总体生存率均无影响（P＞0.05）。结论    胃肠低级别NEN预后好，高级别NEN恶性程度高，预后差，目前指南推荐的化疗方案对其生存率无明显改善。

关键词: 胃肠神经内分泌肿瘤, 临床病理学特征, 预后, 辅助化疗

Abstract: Clinicopathological features and prognosis analysis of 174 gastrointestinal neuroendocrine tumors        ZUO Bing-yu， SUN.Jing， ZANG Lu Department of General Surgery，Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine， Shanghai Minimally Invasive Surgery Center， Shanghai 200025， China
Corresponding author： SUN Jing，E-mail：sj11788@rjh.com.cn 
Abstract    Objective    To analyze the clinicopathological features, treatment effects and prognosis of primary gastrointestinal neuroendocrine neoplasms (GI-NEN). Methods    The clinical data of 174 GI-NEN cases admitted to Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine from January 2015 to December 2020 were retrospectively analyzed, including 35 cases of gastric NEN and 139 cases of intestinal NEN. The survival curve was plotted by Kaplan-Meier method. The 5-year overall survival and 3-year progression-free survival of the gastric and intestinal high-grade NEN groups were compared by the Log-rank test, and the effect of adjuvant chemotherapy on the prognosis of high-grade NEN patients was analyzed. Results    Among the 174 GI- NEN cases, 23 cases of gastric high-grade NEN and 13 cases of intestinal high-grade NEN were collected, and there were 12 cases of gastric low-grade NEN and 126 cases of intestinal low-grade NEN. The survival rate of low-grade NEN in gastrointestinal NEN was significantly better than that of high-grade NEN（P<0.01）. There was no significant difference in overall survival and progression-free survival between gastric high-grade NEN and intestinal high-grade NEN（P＞0.05）. Adjuvant chemotherapy had no effect on the overall survival of gastric and intestinal high-grade NEN（P＞0.05）. Conclusion Gastrointestinal low-grade NEN has a better prognosis, high-grade NEN has higher degree of malignancy and worse prognosis, and the chemotherapy regimen recommended by the current guidelines has no significant improvement in its survival rate.

Key words: gastrointestinal neuroendocrine tumors, clinicopathological features, prognosis, adjuvant chemotherapy