RESUMO
BACKGROUND/AIMS: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a unique subgroup of tumors in the digestive system but with great clinical heterogeneity. The information on clinical characteristics and prognostic factors of Chinese patients is rather limited. METHODOLOGY: We retrospectively analyzed the clinical features, prognostic factors of this disease in a consecutive cohort (N=294) between January 2007 and December 2012. RESULTS: Functioning tumors accounted for 9.2%. Rectum was the most predominant GEP-NETs locations. Abdominal pain occurred in 46.5% patients which was the most common initial symptom. G1, G2 and G3 tumors accounted for 41.5%, 34.7% and 23.8%, respectively. Endoscopy provided the highest detection rate of 95.7%. Consistence between endoscopic ultrasound guided fine needle aspiration biopsy (EUS-FNAB) and surgically obtained histological Ki-67 index was 36.4%. Serum CgA test showed a 80.0% consistence with the tissue biopsy. The median follow up duration was 2.8 years (0.02-5.90 years), the median survival was 4.8 years, overall 5-year survival rate was 69.6%. We found colonic localization, tumor size larger than 20 mm, G3 tumor and metastasis were associated with worse outcome (p<0.05). CONCLUSION: We found both consistence and differences in GEP-NETs characteristics between our study and previous reports.
Assuntos
Neoplasias Intestinais/patologia , Tumores Neuroendócrinos/secundário , Neoplasias Pancreáticas/patologia , Neoplasias Gástricas/patologia , Adulto , Povo Asiático , Proliferação de Células , China/epidemiologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Endoscopia do Sistema Digestório , Feminino , Humanos , Neoplasias Intestinais/química , Neoplasias Intestinais/etnologia , Neoplasias Intestinais/mortalidade , Neoplasias Intestinais/cirurgia , Estimativa de Kaplan-Meier , Antígeno Ki-67/análise , Masculino , Pessoa de Meia-Idade , Índice Mitótico , Tumores Neuroendócrinos/química , Tumores Neuroendócrinos/etnologia , Tumores Neuroendócrinos/mortalidade , Tumores Neuroendócrinos/cirurgia , Neoplasias Pancreáticas/química , Neoplasias Pancreáticas/etnologia , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/cirurgia , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco , Neoplasias Gástricas/química , Neoplasias Gástricas/etnologia , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/cirurgia , Fatores de Tempo , Resultado do Tratamento , Carga TumoralRESUMO
Three patients with severe acute pancreatitis (SAP) developed into overt abdominal compartment syndrome (ACS) and confirmed or suspected infection of necrotic tissue. We successfully treated these patients by minimally invasive decompression with the assist of laparoscope after the failures of intensive care treatments. This technique we report here may be another safe and effective management for ACS in SAP.
