Abstract:
Objective To explore the clinicopathological characteristics and prognostic factors of neuroendocrine neoplasms (NENs) at different sites in the digestive system.
Methods The clinicopathological parameters and follow-up data were collected from 284 patients with NENs in the digestive system in Tianjin Medical University Cancer Institute and Hospital from March 2011 to December 2015. The incidence and clinicopathological features were compared between the cases of NENs at different sites and survival analysis was performed.
Results In this study, NENs were detected mostly frequently in the pancreas, followed by the colorectum and stomach. In the pancreas, neuroendocrine tumor (NET) G1 (51.8%) and G2 (35.8%) accounted for a large proportion of NENs. World Health Organization (WHO) grades were related to lymph node metastasis, adjacent organ invasion, and nerve invasion (P <0.05 for all) but were not associated with the overall survival time of the patients. The patients with pancreatic NENs with distant metastasis had poor overall survival (P <0.05). Regarding colorectal NENs, most patients had NET G1 (82.5%), and the majority of patients were cured with endoscopic or transanal resection. Patients with NENs, lymph node metastasis, and distant metastasis had poor overall survival (P <0.05 for all). The ratio of male-to-female patients, proportion of patients aged older than 40 years, prevalence of neuroendocrine carcinomas (NECs) and mixed adenoneuroendocrine carcinomas (MANECs), presence of lymph node and distant metastasis, and presence of advanced stage tumors were greater in patients with gastric NENs than in patients with pancreatic and colorectal NENs (P <0.05 for all). WHO grades and lymph node metastasis were associated with the overall survival time of patients with gastric NENs (P <0.05 for both).
Conclusions NENs in the digestive system are a group of heterogeneous tumors with different clinicopathological features at different sites. The distribution and clinicopathological features of Chinese patients with NENs in the digestive system are different from those of European and American patients. More multicenter studies with large sample sizes are still needed to understand the biological behaviors and prognostic factors of NENs at different sites in the digestive system.