3型胃神经内分泌肿瘤临床病理特征及淋巴结转移风险分析

李远良; 苏雯婷; 史艳芬; 谭煌英

doi:10.3969/j.issn.1000-8179.2021.07.286

3型胃神经内分泌肿瘤临床病理特征及淋巴结转移风险分析

doi: 10.3969/j.issn.1000-8179.2021.07.286

李远良^{①, ②,},
苏雯婷^{①, ②},
史艳芬^③,
谭煌英^②, ,

①.
北京中医药大学（北京市100029）
②.
中日友好医院中西医结合肿瘤内科
③.
中日友好医院病理科

基金项目:

国家重点研发计划项目 2019YFB1309704

详细信息

作者简介:
李远良专业方向为神经内分泌肿瘤及消化道肿瘤的中西医结合诊治。E-mail：m18810535660@163.com

通讯作者:
谭煌英 tanhuangying@263.net

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出版历程
- 收稿日期: 2020-10-15
- 刊出日期: 2021-04-15

Clinicopathological features and risk analysis of lymph node metastasis in type 3 gastric neuroendocrine tumor

Yuanliang Li^{①, ②
,},
Wenting Su^{①, ②},
Yanfen Shi^③,
Huangying Tan^{②
, ,}

①.
Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China
②.
Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing 100029, China
③.
Department of Pathology, China-Japan Friendship Hospital, Beijing 100029, China

Funds:

National Key R & D Program of China 2019YFB1309704

More Information

Corresponding author: Huangying Tan; E-mail: tanhuangying@263.net

摘要

摘要: 目的分析无远处转移的3型胃神经内分泌肿瘤（neuroendocrine tumor，NET）的临床病理特征，并探索影响淋巴结转移的危险因素。方法回顾性分析2016年3月至2019年5月就诊于中日友好医院的36例无远处转移的3型胃NET患者临床病理资料，构建逻辑回归模型分析淋巴结转移的危险因素。结果研究纳入36例无远处转移的3型患者，8例（22.2%）出现淋巴结转移。淋巴结转移的患者具有较大的肿瘤直径和较高的Ki-67指数，内镜下溃疡型病灶也更多见（50%），肿瘤T分期以T4为主（50%）。单因素结果显示，肿瘤≥2 cm、溃疡型病灶、病理分级G2/3、T2/4是淋巴结转移的高危因素。而多因素分析发现仅肿瘤直径≥2 cm（OR=8.54，95%CI：1.16~62.96）和溃疡型病灶（OR=10.97，95%CI：1.16~103.52）是影响淋巴结转移的独立因子。结论具备淋巴结转移高危因素的3型胃NET需要在术前全面评估区域淋巴结状态，以选择最佳的治疗方式。
- 3型胃神经内分泌肿瘤 /
- 临床病理特征 /
- 淋巴结转移
Abstract: Objective To analyze clinicopathological features of type 3 gastric neuroendocrine tumor (NET) without distant metastasis and identify risk factors of lymph node metastasis. Methods Data of 36 patients with type 3 gastric NET without metastasis from March 2016 to May 2019 in China-Japan Friendship Hospital were retrospectively analyzed. A Logistic regression model was used to identify risk factors of lymph node metastasis. Results This study included 36 patients, and eight patients (22.2%) had lymph node metastasis. Patients with lymph node metastasis had a larger tumor diameter and higher Ki-67 index than those without lymph node metastasis. In addition, endoscopic ulcerative lesions were more common (50%), and the T staging of the tumor was mainly T4 (50%). Univariate analysis revealed that tumor diameter ≥2 cm, ulcerative lesions, and pathological grade G2/3 and T2/4 were the main risk factors of lymph node metastasis. Multivariate analysis revealed that only tumor diameter ≥2 cm [odds ratio (OR)=8.54; 95%CI: 1.16-62.96] and ulcerative lesions (OR) =10.97; 95%CI: 1.16- 103.52) were independent factors affecting lymph node metastasis. Conclusions In patients with type 3 gastric NET with high risk factors for lymph node metastasis, it is necessary to comprehensively evaluate the regional lymph node status before surgery to select the best treatment.
- type 3 gastric neuroendocrine tumor /
- clinicopathological features /
- lymph node metastasis

HTML全文

表 1 36例无远处转移3型胃NET患者的临床病理资料例（%）

表 2 淋巴结转移患者的单因素及多因素回归分析

表 3 12例行外科手术患者术式、淋巴结状态及清扫范围

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