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分化差的胃神经内分泌肿瘤预后分析

张剑, 臧凤琳, 张家丽, 张新伟

张剑, 臧凤琳, 张家丽, 张新伟. 分化差的胃神经内分泌肿瘤预后分析[J]. 肿瘤防治研究, 2019, 46(5): 447-451. DOI: 10.3971/j.issn.1000-8578.2019.18.1770
引用本文: 张剑, 臧凤琳, 张家丽, 张新伟. 分化差的胃神经内分泌肿瘤预后分析[J]. 肿瘤防治研究, 2019, 46(5): 447-451. DOI: 10.3971/j.issn.1000-8578.2019.18.1770
ZHANG Jian, ZANG Fenglin, ZHANG Jiali, ZHANG Xinwei. Prognosis of Poorly-differentiated Gastric Neuroendocrine Neoplasm[J]. Cancer Research on Prevention and Treatment, 2019, 46(5): 447-451. DOI: 10.3971/j.issn.1000-8578.2019.18.1770
Citation: ZHANG Jian, ZANG Fenglin, ZHANG Jiali, ZHANG Xinwei. Prognosis of Poorly-differentiated Gastric Neuroendocrine Neoplasm[J]. Cancer Research on Prevention and Treatment, 2019, 46(5): 447-451. DOI: 10.3971/j.issn.1000-8578.2019.18.1770

分化差的胃神经内分泌肿瘤预后分析

基金项目: 

国家科技支持计划项目 2015BAI12B12

详细信息
    作者简介:

    张剑(1990-),男,硕士,住院医师,主要从事肿瘤内科治疗

    通讯作者:

    张新伟,E-mail: zhangxinwei@tjmuch.com

  • 中图分类号: R735.2;R730.26

Prognosis of Poorly-differentiated Gastric Neuroendocrine Neoplasm

More Information
  • 摘要:
    目的 

    探讨分化差的胃神经内分泌肿瘤的临床病理特点和辅助治疗对预后的影响。

    方法 

    回顾性分析经根治性手术治疗的胃神经内分泌肿瘤124例,根据肿瘤分类标准对肿瘤进行分类、分级和分期,并进行随访,采用Kaplan-Meier法绘制生存曲线,Log rank检验进行单因素分析,Cox比例风险回归模型进行多因素分析。

    结果 

    胃神经内分泌瘤、胃神经内分泌癌和混合性腺神经内分泌癌的5年生存率分别为100%、52.4%和38.8%,多因素分析示淋巴结转移与否(P=0.030)和有无辅助治疗(P=0.017),尤其是顺铂联合依托泊苷方案(HR=0.051, P=0.015)是影响胃神经内分泌癌患者的独立预后因素;而淋巴结转移、远处转移、TNM分期和有无辅助治疗均不是混合性腺神经内分泌癌患者的独立预后因素。

    结论 

    胃神经内分泌癌患者的预后与淋巴结转移和有无辅助治疗有关,其辅助治疗可以考虑顺铂联合依托泊苷方案。

     

    Abstract:
    Objective 

    To explore the effects of clinicopathological features and adjuvant therapy on the prognosis of patients with poorly-differentiated gastric neuroendocrine tumors.

    Methods 

    We retrospectively analyzed 124 cases of gastric neuroendocrine tumors treated with radical surgery. The neoplasms were classified into different types, grades and stages according to the standard of classification. Follow-up was conducted. The survival curves were drawn by Kaplan-Meier method. Univariate analysis was performed by Log rank test and multivariate analysis was conducted by Cox proportional hazards model.

    Results 

    The 5-year survival rates of gastric neuroendocrine tumor, gastric neuroendocrine carcinoma and gastric mixed adenoneuroendocrine carcinoma patients were 100%, 52.4% and 38.8%, respectively. Multivariate analysis showed that lymph node metastasis (P=0.030) and adjuvant therapy (P=0.017), especially cisplatin combined with etoposide regimen (HR=0.051, P=0.015) were independent prognostic factors for patients with gastric neuroendocrine carcinoma; while lymph node metastasis, distant metastasis, TNM stage and adjuvant therapy were not independent prognostic factors for patients with mixed neuroendocrine carcinoma.

    Conclusion 

    The prognosis of patients with gastric neuroendocrine carcinoma is related to lymph node metastasis and adjuvant treatment, and cisplatin plus etoposide regimen is a reasonable choice for adjuvant treatment.

     

  • 作者贡献
    张剑:  收集资料、分析数据、撰写论文
    臧凤琳:  病理阅片
    张家丽:  收集资料、论文修改
    张新伟:  论文修改
  • 图  1   病例筛选

    Figure  1   Case screening

    图  2   各型g-NEN患者生存情况比较

    Figure  2   Survival of all types of g-NEN patients

    图  3   有无辅助治疗对TNM Ⅲ+Ⅳ胃MANEC患者生存的影响

    Figure  3   Effect of adjuvant therapy on survival of patients with TNM Ⅲ+Ⅳ gastric MANEC

    图  4   含铂化疗方案对不同Ki-67指数的NEC患者预后的影响

    Figure  4   Effects of chemotherapy with platinum on prognosis of patients with different Ki-67 index

    表  1   各型g-NEN特点的比较

    Table  1   Comparison of characteristics of each type of g-NENs

    下载: 导出CSV

    表  2   胃NEC+MANEC患者生存分析

    Table  2   Survival of gastric NEC+MANEC patients

    下载: 导出CSV

    表  3   NEC患者预后的多因素分析

    Table  3   Multivariate analysis of prognosis of NEC patients

    下载: 导出CSV

    表  4   有关胃NEC和MANEC辅助治疗的研究

    Table  4   Studies on adjuvant therapy of gastric NEC and MANEC

    下载: 导出CSV
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出版历程
  • 收稿日期:  2018-11-20
  • 修回日期:  2018-12-28
  • 网络出版日期:  2024-01-12
  • 刊出日期:  2019-05-24

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