摘要
目的探讨胃神经内分泌肿瘤G_(1)/G_(2)患者经内镜切除与外科手术的疗效及预后,寻找肿瘤复发的危险因素。方法收集我院2006年11月至2022年5月确诊为胃神经内分泌肿瘤G_(1)/G_(2)的病例,分析其临床病理特征及术后疗效,并用Cox回归分析肿瘤复发的危险因素。结果92例胃神经内分泌肿瘤患者中G_(1)65例,G_(2)27例。70例行内镜切除,22例行外科手术,两组肿瘤直径均较小,均以胃体多见,浸润深度多局限于黏膜层及黏膜下层。内镜切除组住院天数、住院费用均显著少于外科手术组,且术中出血发生率显著低于外科手术组(P均<0.001)。内镜切除组1、3年疾病复发率分别为7.1%、30.0%;外科手术组分别为4.5%、13.6%。单因素分析显示,切缘、肿瘤分型与G_(1)/G_(2)肿瘤复发相关(P<0.05),而年龄、性别、肿瘤部位、浸润深度、病理分级、手术方式、临床症状对肿瘤复发无影响(P>0.05)。多因素Cox回归显示,肿瘤分型、切缘是影响肿瘤复发的独立危险因素。结论对于胃神经内分泌肿瘤G_(1)/G_(2)患者,内镜切除和外科手术远期疗效未见明显差异,但内镜切除创伤小、住院时间短、住院花费少,更应放在首位考虑。
Objective To investigate the efficacy and prognosis of endoscopic resection and surgical treatment of G_(1)/G_(2) gastric neuroendocrine neoplasms(GNENs)patients,and to find risk factors for tumor recurrence.Methods The cases diagnosed with G_(1)/G_(2) GNENs in our hospital from Nov.2006 to May 2022 were collected,and their clinicopathological features and postoperative outcome were analysed.Risk factors of GNENs recurrence were analyzed by Cox regression analysis.Results Among the 92 GNENs patients,65 were G_(1) and 27 were G_(2).There were 70 patients with endoscopic resection,and 22 patients with surgery treatment.The tumor diameters of patients in the two groups were both small.Tumors were almost located in the gastric body,and the depth of infiltration was mostly limited to the mucosal layer and submucosal layer.The hospital stay,hospitalization cost and the incidence of intraoperative bleeding in endoscopic resection group were much lower than those in the surgical treatment group(P<0.001).The recurrence rates of the 1 year and 3 years in the endoscopic resection group were 7.1%and 30.0%,respectively,and the surgical treatment group were 4.5%and 13.6%.Univariate analysis showed that incision margin and tumor type were associated with recurrence of G_(1)/G_(2) GNENs(P<0.05),while age,sex,tumor site,depth of infiltration,pathological grade,surgical method,and clinical symptom had no effect on tumor recurrence(P>0.05).Multivariate Cox regression showed that tumor type and resection margin were independent factors affecting tumor recurrence.Conclusion For patients with G_(1)/G_(2) GNENs,there is no significant difference in the long-term efficacy of endoscopic resection and surgical treatment,but endoscopic resection has little trauma,short hospital stay and less hospitalization cost,so we should put it in the first place.
作者
刘金燕
项英
袁颖
王振宇
王亚楠
吕瑛
王雷
徐桂芳
LIU Jinyan;XIANG Ying;YUAN Ying;WANG Zhenyu;WANG Ya′nan;LYU Ying;WANG Lei;XU Guifang(Department of Gastroenterology,Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)
出处
《胃肠病学和肝病学杂志》
CAS
2023年第8期841-846,共6页
Chinese Journal of Gastroenterology and Hepatology
关键词
胃神经内分泌肿瘤
临床病理特征
术后疗效
预后
Gastric neuroendocrine neoplasms
Clinicopathologic features
Postoperative outcome
Prognosis
