摘要
目的 探讨G1/G2级胃肠道神经内分泌肿瘤(GI-NENs)的临床病理特征对总体生存期(OS)和无疾病生存期(DFS)的影响。方法 回顾性分析2011年1月—2020年12月江苏大学附属宜兴医院94例G1/G2级GI-NENs患者的临床病理及随访资料,采用Kaplan-Meier法进行生存分析,Cox比例风险模型筛选影响OS和DFS的因素。结果 94例患者中,男45例(47.9%),平均年龄(55.32±13.19)岁,平均病灶直径(0.84±0.80)cm,术后病理切缘达到R0切除84例;血清(血浆)嗜铬粒蛋白A(CgA)阳性40例(42.6%),突触素(Syn)阳性93例(98.9%),神经元特异性烯醇化酶(NSE)阳性27例(28.7%),Ki-67指数平均值为(2.53±2.34)%;病理分级G1级83例(88.3%),G2级11例(11.7%)。中位随访时间45(10~131)个月,Kaplan-Meier分析显示,WHO病理分级和Stage分期低级别、肿瘤直径<1 cm、相对年轻、CgA阴性患者有较好的OS和DFS(P<0.05),而切缘阳性、采取内镜下圈套电凝切除、多发肿瘤与较短的DFS有关(P<0.05)。Cox比例风险模型多因素分析显示,切缘、肿瘤直径是与DFS相关的独立预后因素。结论 肿瘤直径、切缘、CgA与G1/G2级GI-NENs患者的预后有关,需要针对不同的肿瘤大小、部位、WHO分级分期制定合适的治疗方案。
Objective To explore the clinicopathological features of gastrointestinal neuroendocrine neoplasms(GI-NENs) at grades G1/G2 on overall survival(OS) and disease-free survival(DFS).Methods A total of 94 patients of GI-NENs patients at grades G1/G2 who were admitted to Yixing Hospital Affiliated to Jiangsu University between January 2011 to December 2020 were enrolled and their clinicopathological and follow-up data were retrospectively analyzed. Survival analysis was performed by Kaplan-Meier method and the Cox proportional hazards model was used for investigating OS and DFS.Results Among the 94 patients, there were 45(47.9%) men with an average age of(55.32±13.19) years. The mean lesion diameter was(0.84±0.80) cm. There were 84 cases with complete tumor resection(R0). Furthermore, 40(42.6%) cases were chromogranin A(CgA)-positive, 93(98.9%) cases were synapsin(Syn)-positive, 27(28.7%) cases were neuron-specific enolase(NSE)-positive and the mean Ki-67 index was(2.53±2.34)%. Moreover, 83 cases(88.3%) were at grade G1, and 11 cases(11.7%) were at grade G2. The median follow-up time was 45(10-131) months. Kaplan-Meier analysis showed that lower WHO pathological grade and stage, tumor diameter <1 cm, relatively young age and CgA-negative patients had better OS and DFS(both P<0.05), while positive margin, transendoscopic trap electrocoagulation and multiple tumors were associated with shorter DFS(P<0.05). According to the multivariate analysis of the Cox proportional hazards model, resection margin and tumor diameter were independent prognostic factors associated with DFS.Conclusions Tumor diameter, margin, and CgA are associated with the prognosis of GI-NENs patients. Appropriate therapeutic strategies should be developed for patients with different tumor sizes, sites, WHO grades and stages.
作者
刘雷
钱佶
毛伯能
姚镇东
赵建奇
LIU Lei;QIAN Ji;MAO Boneng;YAO Zhendong;ZHAO Jianqi(Department of Gastroenterology,Yixing Hospital Affiliated to Jiangsu University,Yixing,Jiangsu 214000,China;Department of Emergency,Xuzhou Mining Group General Hospital,the Second Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221006)
出处
《徐州医科大学学报》
CAS
2022年第12期896-901,共6页
Journal of Xuzhou Medical University
基金
无锡临床科学技术基金资助项目(Q202062
Q201924)。
