Single center clinical study of rectal neuroendocrine neoplasms / 肿瘤

ABSTRACT

Objective: To investigate the clinicopathological features, diagnosis, treatment, prognosis and the related factors of patients with rectal neuroendocrine neoplasms (NENs). Methods: The clinicopathological characteristics and follow-up data of 80 patients with rectal NENs who were treated in the First Affiliated Hospital of Zhengzhou University from January 2011 to March 2016 were collected. All specimens were immunohistochemically stained and staged. The Kaplan-Meier method and COX proportional hazard model were used for univariate and multivariate analyses of prognosis-related factors. Results: Among the 80 patients, there were 47 males and 33 females; the median age was 52 years old (range: 20-75 years). The mean diameter of tumors was 1.65 cm. The common symptoms were changes of bowel habits (37.5%), hematochezia (23.7%) and abdominal pain (16.3%). The positive rates of chromogranin A (CgA) and synaptophysin (Syn) were 50.0% and 97.5%, respectively. Seventy-four cases underwent surgical treatment, and 12 cases received chemotherapy. The follow-up time ranged from 3 to 57 months. The median progressionfree survival time was 20 months (95% confidence interval: 15.354-24.646 months). The 1- and 3-year overall survival rates were 93.4% and 85.7%, respectively. Multivariate analysis showed that the Eastern Cooperative Oncology Group (ECOG) performance status (PS) score (P < 0.001), tumor diameter (P = 0.010), Ki-67 index (P = 0.020) and TNM stage (P = 0.012) were independent risk factors associated with prognosis. Conclusion: Rectal NENs is rare, but the morbidity is significantly increased. Surgical resection is the preferred treatment. The independent prognostic factors are ECOG PS score, tumor diameter, Ki-67 index and TNM stage.