| Ping Yang,Jie Liu,Dongliang Lin,Haiyang Fu,Jing Chu,Feng Li,Guiyan Han,Yujun Li,Weiwei Fu. Clinical characteristics and prognostic analysis of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN). Oncol Transl Med, 2014, 13: 578-583. |
| 消化道神经内分泌瘤临床病理特征及预后因素分析 |
| Clinical characteristics and prognostic analysis of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) |
| Received:November 10, 2014 Revised:December 04, 2014 |
| DOI：10.1007/s10330-314-0022-8 |
| 中文关键词: 神经内分泌瘤；病理学，预后；多因素分析 |
| 英文关键词: neuroendocrine neoplasm (NEN); pathology, prognosis; multiple factor analysis |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Ping Yang | Department of Pathology, the Affiliated Hospital, Qingdao University, Qingdao 266003, China | 15865630@163.com | | Jie Liu | 2.Digestion Department of internal medicine hospital Economic and Technological Development Zone,Yantai 264000,China | | | Dongliang Lin | Department of Pathology, the Affiliated Hospital, Qingdao University, Qingdao 266003, China | | | Haiyang Fu | Department of Pathology, the Affiliated Hospital, Qingdao University, Qingdao 266003, China | | | Jing Chu | Department of Pathology, the Affiliated Hospital, Qingdao University, Qingdao 266003, China | | | Feng Li | Department of Pathology, the Affiliated Hospital, Qingdao University, Qingdao 266003, China | | | Guiyan Han | Department of Pathology, the Affiliated Hospital, Qingdao University, Qingdao 266003, China | | | Yujun Li* | Department of Pathology, the Affiliated Hospital, Qingdao University, Qingdao 266003, China | liyujun.66@163.com | | Weiwei Fu* | Department of Pathology, the Affiliated Hospital, Qingdao University, Qingdao 266003, China | |
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| 中文摘要: |
| 目的 通过对消化道神经内分泌瘤(GEP—NEN)患者的临床病理特征、免疫组化资料、病理分级和预后等进行分析，探寻不同病理分级肿瘤之间的神经内分泌标记物表达差异及影响肿瘤预后的危险因素。方法 回顾性分析2003年8月至2013年12青岛大学附属医院病理科诊断的119例GEP-NEN的临床病理资料。其中男性72例，女性47例。年龄19岁至86岁，中位年龄53岁。应用免疫组织化学染色及方差分析比较不同病理分级的肿瘤CgA和Syn表达情况。运用Kaplan—Meier法进行生存分析，采用多因素Cox回归分析筛选影响患者生存的独立危险因素。结果119例GEP-NEN患者最常见的发病部位为胰腺(45/119,37.82％)和直肠(33/119,27.73％)。女性相比男性NEN的发病年龄较低。在G2肿瘤中Syn的表达强度比G1和G3中高，而CgA染色无此特征；在不同病理学分类中CgA和Syn表达均无明显差异。全部患者中位随访18.9(0.1—133.4)个月；随访期间13例(10.92％)患者死亡。多因素分析结果显示：NEN肿瘤分级、神经脉管侵犯、性别是影响患者生存时间的独立危险因素。结论 GEP-NEN可发生于消化系统任何部位，临床表现缺乏特异性。G2肿瘤中Syn呈强表达，检测Syn的表达对于G2和 G1、G3肿瘤的鉴别诊断有辅助作用。NEN肿瘤分级、神经脉管侵犯、性别是判断预后的重要因素。 |
| 英文摘要: |
| Objective: The aim of the study was to analyze the clinicopathologic characteristics of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) and to explore the prognostic factors for patients and differences of immunohistochemical markers between neuroendocrine tumor (NET) and neuroendocrine carcinoma (NEC). Methods: Retrospective reviews were conducted for the charts of 119 patients with GEP-NEN at the Affiliated Hospital of Qingdao University (China) from August 2003 to December 2013. Kaplan-Meier method was used to do the overall survivals analysis for the patients at different levels of predictive factors. Meanwhile, Cox proportional hazard model was used to select independent risk factors of survival. Analysis of variance was used to compare the expression of immunohistochemical markers among different pathological grades. Results: Among 119 patients, pancreas (45/119, 37.82%) and rectum (33/119, 27.73%) were mostly involved. The onset age of GEP-NEN in female group was younger than that of the male group. There were 13 deaths (10.92%) during 18.9 (0.1–133.4) months follow-up period. Multivariate analysis indicated that neural invasion, gender and pathological grades of NET and NEC were independent risk factors. In neuroendocrine neoplasm (NEN), Syn expression in G2 was higher than G1 and G3, while CgA showed no significant difference. All markers showed no significant differences between NET and NEC. Conclusion: GEP-NEN may occur at multiple sites of digestive system and lack specific clinical manifestations. Syn expression detected for the prognosis of G1, G2 and G3 tumors have clinical significance. Neural invasion, sex and pathological grades were independent prognostic factors for GEP-NEN patients. No significant difference was found in different pathological grades of NET and NEC. |
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