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目的探讨胃肠道神经内分泌肿瘤的临床特点以及治疗方案。方法回顾性统计2011年1月至2015年7月期间徐州医学院附属医院收治的74例胃肠道神经内分泌肿瘤患者的临床资料,并对其临床特点及治疗方案进行分析。结果胃肠道神经内分泌肿瘤的发病数逐年增加。共有74例胃肠道神经内分泌肿瘤患者,男47例,女27例,男女比例为1.74:1;年龄24~82岁,中位年龄57.5岁。肿瘤位于胃部最多(38例),其次是直肠(23例),结肠和十二指肠分别有12例和1例。肿瘤位于胃结肠者均无特异性的临床症状,位于直肠者中有腹泻表现者3例,即有功能性症状者占4.1%(3/74),非功能性症状者占95.9%(71/74)。74例患者中行根治性手术者34例,内镜下切除者23例,共占77.0%(57/74);另外行局部切除者8例,姑息性手术切除者4例,保守治疗者5例。淋巴结转移与患者性别以及肿瘤大小、浸润深度和分类相关(P<0.05),与肿瘤发生部位无关(P>0.05)。术前远处转移与肿瘤大小和浸润深度相关(P<0.05)。胃肠道神经内分泌肿瘤中,Syn检出阳性率为96.1%(49/51),Cg A检出阳性率为72.9%(35/48),两者之间的差异有统计学意义(P<0.01)。结论胃肠道神经内分泌肿瘤发病数逐年增加,主要的治疗方案为根治性手术和内镜下治疗,Syn和Cg A的检测有利于神经内分泌肿瘤的诊断。
Objective To investigate the clinical features and treatment of gastrointestinal neuroendocrine tumors. Methods The clinical data of 74 patients with gastrointestinal neuroendocrine tumors admitted to the Affiliated Hospital of Xuzhou Medical College from January 2011 to July 2015 were retrospectively analyzed. The clinical features and treatment regimens were analyzed. Results The incidence of gastrointestinal neuroendocrine tumors increased year by year. A total of 74 patients with gastrointestinal neuroendocrine tumors, 47 males and 27 females, male to female ratio of 1.74: 1; aged 24 to 82 years, the median age of 57.5 years. Tumors were most abundant in the stomach (38 cases), followed by the rectum (23 cases), in the colon and duodenum in 12 cases and in 1 case, respectively. Tumors located in the stomach and intestine had no specific clinical symptoms. There were 3 cases of diarrhea in the rectum, accounting for 4.1% (3/74) with functional symptoms and 95.9% with non-functional symptoms (71 / 74). Among the 74 patients, 34 were undergone radical surgery and 23 underwent endoscopic resection, accounting for 77.0% (57/74). In addition, 8 were treated by partial excision, 4 were treated by palliative resection, and 5 were conservative treatment . Lymph node metastasis was correlated with gender and tumor size, depth of invasion and classification (P <0.05), but not with tumor location (P> 0.05). Preoperative distant metastasis was associated with tumor size and depth of invasion (P <0.05). In gastrointestinal neuroendocrine tumors, the positive rate of Syn was 96.1% (49/51) and the positive rate of Cg A was 72.9% (35/48), the difference was statistically significant (P < 0.01). Conclusions The incidence of neuroendocrine tumors in gastrointestinal tract has been increasing year by year. The main treatment options are radical surgery and endoscopic treatment. The detection of Syn and Cg A is beneficial to the diagnosis of neuroendocrine tumors.