中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2015年
15期
2803-2807
,共5页
张瑞晓%王琦%武希润%申慧琴
張瑞曉%王琦%武希潤%申慧琴
장서효%왕기%무희윤%신혜금
神经内分泌瘤%胃肠胰神经内分泌肿瘤%临床特征%治疗
神經內分泌瘤%胃腸胰神經內分泌腫瘤%臨床特徵%治療
신경내분비류%위장이신경내분비종류%림상특정%치료
Neuroendocrine tumors%Gastroenteropancreatic neuroendocrine neoplasm%Clinical characteristics%Therapy
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（CgA）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（P＜0.05）。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P＜0.05）。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，CgA、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。
目的：探討112例胃腸胰神經內分泌腫瘤的臨床特點、病理特點，以提高對該疾病的認識及診治水平，減少誤診漏診。方法選取2009年1月至2014年1月山西省腫瘤醫院收治的經手術病理確診的112例胃腸胰神經內分泌腫瘤患者的臨床資料，對其臨床錶現、內鏡、病理錶現、診斷及治療等進行迴顧性分析。結果本組胃腸胰神經內分泌腫瘤112例，男91例，女21例，年齡在39～78歲，平均髮病年齡（59.54±10.05）歲，髮病部位最常見于胃，其次食管、直腸、結腸。主要癥狀為腹痛、腹脹、吞嚥不暢，無1例齣現類癌綜閤徵。免疫組化診斷嗜鉻顆粒蛋白A（CgA）和突觸素（Syn）的暘性率分彆為71%、99%。這類腫瘤的轉移與病竈浸潤深度相關，噹浸潤深度增加，轉移率也升高（P＜0.05）。組織學類型與腫瘤大小、週圍組織浸潤深度、腫瘤標記物CEA、CA242密切相關（χ2＝37.958、12.987、8.898、6.524，均P＜0.05）。腫瘤TNM分期越高，腫瘤組織學類型分級越高（r=0.308，P=0.001）；同時組織學類型分級越高，腫瘤標記物異常越多。結論胃腸胰神經內分泌腫瘤是一種少見的疾病，臨床錶現不典型，最常見的髮生部位是胃，很多確診病例已經是晚期。確診依靠病理檢查，CgA、Syn的聯閤檢測可協助診斷。胃腸胰神經內分泌腫瘤以手術治療為主。
목적：탐토112례위장이신경내분비종류적림상특점、병리특점，이제고대해질병적인식급진치수평，감소오진루진。방법선취2009년1월지2014년1월산서성종류의원수치적경수술병리학진적112례위장이신경내분비종류환자적림상자료，대기림상표현、내경、병리표현、진단급치료등진행회고성분석。결과본조위장이신경내분비종류112례，남91례，녀21례，년령재39～78세，평균발병년령（59.54±10.05）세，발병부위최상견우위，기차식관、직장、결장。주요증상위복통、복창、탄인불창，무1례출현유암종합정。면역조화진단기락과립단백A（CgA）화돌촉소（Syn）적양성솔분별위71%、99%。저류종류적전이여병조침윤심도상관，당침윤심도증가，전이솔야승고（P＜0.05）。조직학류형여종류대소、주위조직침윤심도、종류표기물CEA、CA242밀절상관（χ2＝37.958、12.987、8.898、6.524，균P＜0.05）。종류TNM분기월고，종류조직학류형분급월고（r=0.308，P=0.001）；동시조직학류형분급월고，종류표기물이상월다。결론위장이신경내분비종류시일충소견적질병，림상표현불전형，최상견적발생부위시위，흔다학진병례이경시만기。학진의고병리검사，CgA、Syn적연합검측가협조진단。위장이신경내분비종류이수술치료위주。
ObjectiveThis paper mainly focused on the clinical features, pathological features of 112 cases of gastrointestinal and pancreatic neuroendocrine neoplasms to improve the knowledge of the level of diagnosis and treatment of diseases to reduce the misdiagnosis and missed diagnosis. MethodsWe colected the clinical data of 112 patients with gastroenteropancreatic neuroendocrine neoplasms, who were diagnosed by operation and pathology in Shanxi Provincial Tumor Hospital dating from January 2009 to January 2014. In this present paper, the clinical manifestation, endoscopic, pathological manifestations, diagnosis and treatment were analyzed retrospectively.ResultsThis group of gastroenteropancreatic neuroendocrine neoplasms in 112 cases includes 91 cases from male, 21 cases from female, and their ages are between 39-78 years old, the average age was (59.54±10.05) years. The most common site of onset was in the stomach, esophagus, colon, and rectum was the other site. The main symptoms were abdominal pain, abdominal distension, swalowing unsmooth, but no case was from carcinoid syndrome. The positive rate of immunohistochemical diagnosis of chromogranin A and synaptophysin were 71%, 99%, respectively. The metastasis and lesion depth of this tumor was related. When the invasion depth increased, metastatic rate also increased. The histological type and tumor size, depth of invasion, tumor markers CEA, CA242 were closely related (χ2=37.958, 12.987, 8.898, 6.524, P<0.05). The higher tumor TNM stage, tumor histological type classification was higher, the correlation coefficient was 0.308,P=0.001; At the same time, the higher the grade of histological types was, the more the tumor marker of abnormal was.ConclusionsThe gastroenteropancreatic neuroendocrine neoplasms is a rare disease. The clinical manifestation is not typical. The most common site is the occurrence of stomach. A lot of confirmed cases is already late. Diagnosis depends on pathological examination and the combined detection of CgA, Syn. The treatment of this tumor mainly depends on the operation.
