ABSTRACT
Objective To investigate the epidemiology, clinical manifestations, diagnosis, treatment and prognosis of neuroendocrine tumors (NETs). Methods Medical records of 265 patients with neuroendocrine tumors diagnosed and treated in our hospital from January 2006 to August 2015 were collected and retrospectively reviewed in this study. The clinicopathological data including gender, age of onset, initial symptoms, primary site, pathological conditions, diagnosis, treatment, prognosis and follow up were analyzed. Results The gender ratio M/F of the 265 cases was 160:105 (1.5:1), with mean age of (55.8±2.7) years, and the high incidence was in age of 55-65 years. The tumors were located in the colon and rectum (127 cases, 47.9％), lung (59 cases, 22.3％), stomach (21 cases, 7.8％), appendix (15 cases, 5.7％), small intestine (especially in the duodenum and pancreas, 10 cases, 3.8％), mammary gland (11 cases, 4.2％), neck (10 cases, 3.8％) and unknown primary site (12 cases, 4.5％). Patients with different tumor sites showed different symptoms. Patients with colorectal tumors mainly manifested as changes in bowel habits, such as diarrhea, constipation and blood in stool. The main manifestation of patients with primary pulmonary symptoms was cough or bloody sputum. The patients with tumors at stomach, appendix or small intestine showed many discomfort, such as abdominal pain and abdominal distention. Among the 265 cases, 186 patients were diagnosed as phase G1 (70.2％), 54 patients were diagnosed as phase G2 (20.4％) and 25 patients were diagnosed as phase G3 (9.4％). Immunohistochemistry showed that synaptophysin (Syn) was positive in 228 cases (86.4％), chromaffin A (CgA) was positive in 102 cases (38.5％), and C56 was positive in 74 cases (27.9％). A total of 232 patients were treated with surgery (87.5％), 28 patients received radiotherapy or chemotherapy treatment (10.6％) and 5 patients were not treated. One hundred and ninety-eight patients were followed up at least 1 time, and the follow-up rate was 74.7％. The median follow-up time was 38 months. No tumor related death was found in patients with phase G1 during the follow-up, 6 cases of tumor associated death were found in patients with phase G2 and 19 cases of cancer related death were found in patients with phase G3. Metastasis was found in all 23 patients with tumor related death. The survival rate of patients with neuroendocrine tumor (G1+G2) was significantly higher than that of patients with neuroendocrine carcinoma (G3, Log rankχ2=13.774,P<0.01). Conclusion The males have a higher incidence rate of NETs than females. Patients with different tumor sites showed different symptoms. The most common primary sites of NETs are the digestive tract, especially in patients with colorectal cancer. The more late the pathological stage, the worse the prognosis.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the influence factor of stress ulcer bleeding(SUB) in postoperative rectal cancer patients.</p><p><b>METHODS</b>Clinical data of rectal cancer patients undergoing operation in our hospital were analyzed retrospectively. Patients were divided into case group and control group according to the postoperative occurrence of SUB. Univariate analysis combined with multivariate analysis were used to evaluate the influence factors.</p><p><b>RESULTS</b>Chronic diseases incidence of case group was higher than that of control group. Except for renal failure, the incidence of postoperative complications of case group was higher than that of control group. Univariate analysis revealed that age, chronic disease, preoperative, and postoperative complications had statistical significant differences(P<0.05). Multivariate analysis identified that age(OR=2.893, 95%CI:1.118-5.543), drinking history(OR=3.839, 95%CI:1.012-6.654), preoperative chronic disease(OR=4.646, 95%CI:1.872-8.892), intraoperative bleeding volume(OR=5.129, 95%CI:2.829-9.328), occurrence of severe complications after surgery(OR=6.576, 95%CI:4.539-13.278), postoperative application of glucocorticoid(OR=2.978, 95%CI:1.013-4.512), preoperative application of non-steroidal anti-inflammatory drugs(OR=2.126, 95%CI:1.287-7.636) were risk factors for SUB in rectal cancer patients after operation. Postoperative prophylactic use antacids(OR=0.102, 95%CI:0.017-0.196) was protective factor for SUB patients.</p><p><b>CONCLUSION</b>Effective measures should be taken for high-risk patients, in order to improve the prognosis of patients.</p>