胃肠胰神经内分泌肿瘤112例临床特点分析

发布时间：2018-04-13 13:13

本文选题：神经内分泌瘤 + 胃肠胰神经内分泌肿瘤　；参考：《中华临床医师杂志(电子版)》2015年15期

【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(Cg A)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(P0.05)。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P0.05)。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,Cg A、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。
[Abstract]:Objective to investigate the clinical and pathological features of 112 cases of gastrointestinal and pancreatic neuroendocrine tumors in order to improve the understanding, diagnosis and treatment of the disease and reduce misdiagnosis and missed diagnosis.Methods from January 2009 to January 2014, 112 patients with gastrointestinal and pancreatic neuroendocrine tumors admitted to Shanxi Provincial Cancer Hospital were selected. The clinical manifestations, endoscopy and pathological findings were analyzed.The diagnosis and treatment were analyzed retrospectively.Results 112 cases of gastrointestinal and pancreatic neuroendocrine neoplasms, 91 males and 21 females, were aged 3978 years. The average age of onset was 59.54 卤10.05 years old. The most common site was the stomach, followed by esophagus, rectum and colon.The main symptoms were abdominal pain, abdominal distension, dysphagia and no carcinoid syndrome.The positive rates of A(Cg A and synaptophysin in immunohistochemical diagnosis were 71% and 99%, respectively.The metastasis of these tumors was correlated with the depth of invasion, and when the depth of invasion increased, the rate of metastasis also increased (P 0.05).Histological types were closely related to tumor size, depth of infiltration of surrounding tissues and tumor marker CEA CA242 (蠂 ~ 2 37. 958 ~ 12. 987 ~ 8. 898 ~ 6. 524, all P 0. 05).The higher the TNM stage was, the higher the histological grade was, and the higher the histological grade was, the more abnormal tumor markers were.Conclusion Gastrointestinal and pancreatic neuroendocrine tumor is a rare disease with atypical clinical manifestations and the most common site is the stomach.The diagnosis depends on the combined detection of C g A and Syn.Gastrointestinal and pancreatic neuroendocrine tumors are mainly treated by surgery.
【作者单位】：山西医科大学第二临床医学院消化内科;
【分类号】：R735

【参考文献】