摘要
目的：探讨112例胃肠胰神经内分泌肿瘤的临床特点、病理特点，以提高对该疾病的认识及诊治水平，减少误诊漏诊。方法选取2009年1月至2014年1月山西省肿瘤医院收治的经手术病理确诊的112例胃肠胰神经内分泌肿瘤患者的临床资料，对其临床表现、内镜、病理表现、诊断及治疗等进行回顾性分析。结果本组胃肠胰神经内分泌肿瘤112例，男91例，女21例，年龄在39～78岁，平均发病年龄（59.54±10.05）岁，发病部位最常见于胃，其次食管、直肠、结肠。主要症状为腹痛、腹胀、吞咽不畅，无1例出现类癌综合征。免疫组化诊断嗜铬颗粒蛋白A（CgA）和突触素（Syn）的阳性率分别为71%、99%。这类肿瘤的转移与病灶浸润深度相关，当浸润深度增加，转移率也升高（P＜0.05）。组织学类型与肿瘤大小、周围组织浸润深度、肿瘤标记物CEA、CA242密切相关（χ2＝37.958、12.987、8.898、6.524，均P＜0.05）。肿瘤TNM分期越高，肿瘤组织学类型分级越高（r=0.308，P=0.001）；同时组织学类型分级越高，肿瘤标记物异常越多。结论胃肠胰神经内分泌肿瘤是一种少见的疾病，临床表现不典型，最常见的发生部位是胃，很多确诊病例已经是晚期。确诊依靠病理检查，CgA、Syn的联合检测可协助诊断。胃肠胰神经内分泌肿瘤以手术治疗为主。
ObjectiveThis paper mainly focused on the clinical features, pathological features of 112 cases of gastrointestinal and pancreatic neuroendocrine neoplasms to improve the knowledge of the level of diagnosis and treatment of diseases to reduce the misdiagnosis and missed diagnosis. MethodsWe colected the clinical data of 112 patients with gastroenteropancreatic neuroendocrine neoplasms, who were diagnosed by operation and pathology in Shanxi Provincial Tumor Hospital dating from January 2009 to January 2014. In this present paper, the clinical manifestation, endoscopic, pathological manifestations, diagnosis and treatment were analyzed retrospectively.ResultsThis group of gastroenteropancreatic neuroendocrine neoplasms in 112 cases includes 91 cases from male, 21 cases from female, and their ages are between 39-78 years old, the average age was （59.54±10.05） years. The most common site of onset was in the stomach, esophagus, colon, and rectum was the other site. The main symptoms were abdominal pain, abdominal distension, swalowing unsmooth, but no case was from carcinoid syndrome. The positive rate of immunohistochemical diagnosis of chromogranin A and synaptophysin were 71%, 99%, respectively. The metastasis and lesion depth of this tumor was related. When the invasion depth increased, metastatic rate also increased. The histological type and tumor size, depth of invasion, tumor markers CEA, CA242 were closely related （χ2=37.958, 12.987, 8.898, 6.524, P〈0.05）. The higher tumor TNM stage, tumor histological type classification was higher, the correlationcoefficient was 0.308,P=0.001; At the same time, the higher the grade of histological types was, the more the tumor marker of abnormal was.ConclusionsThe gastroenteropancreatic neuroendocrine neoplasms is a rare disease. The clinical manifestation is not typical. The most common site is the occurrence of stomach. A lot of confirmed cases is already late. Diagnosis depends on pathological examination and the combined detection of CgA, Syn. The treatment of this tumor mainly depends on the operation.
出处
《中华临床医师杂志（电子版）》
CAS
2015年第15期16-20,共5页
Chinese Journal of Clinicians(Electronic Edition)
关键词
神经内分泌瘤
胃肠胰神经内分泌肿瘤
临床特征
治疗
Neuroendocrine tumors
Gastroenteropancreatic neuroendocrine neoplasm
Clinical characteristics
Therapy
