胃神经内分泌肿瘤诊疗及预后回顾性剖析.docVIP

胃神经内分泌肿瘤诊疗及预后回顾性剖析 　　[摘要] 目的 探讨胃神经内分泌肿瘤（gastric neuroendoerine neoplasms，GNENs）的分型诊断方法、治疗方案及愈后。方法 回顾性分析2005年3月～2015年3月其间确诊的26例胃神经内分泌肿瘤患者临床病理资料，治疗过程及预后追踪。 结果 26例患者初诊多表现为腹部疼痛不适、头晕、恶心、便血、腹泻，均行胃镜检查及活检。临床Ⅰ型12例，病灶呈息肉型或隆起型，位于胃体7例，胃底5例，病理分级均为G1级，病灶平均直径1.5 cm。临床Ⅱ型5例，病灶呈息肉型或隆起型，胃底2例，胃体2例，胃窦1例，平均直径2 cm；G1级4例；G2级1例，伴胃溃疡3例。临床Ⅲ型7例，3例息肉型，4例溃疡型，平均直径4 cm，胃底3例、胃体3例、胃窦1例；G2级5例，G3级2例；伴有转移6例。Ⅳ型2例，单发，2例位于胃窦，平均直径5.5 cm，均伴有转移。11例患者行内镜切除术，15例患者行外科根治性切除术。随访26例，第1、3、5年总体生存率分别为100.00%、84.61%、65.38%。结论 GNENs临床表现无明显特异性，肿瘤好发胃底、胃体部，治疗主要根据肿瘤的分级及分期情况，选择内镜或手术切除。 　　[关键词] 胃神经内分泌瘤；诊断方法；治疗方案；预后 　　[中图分类号] R735.2 [文献标识码] B [文章编号] 1673-9701（2016）12-0027-03 　　Retrospective analysis of diagnosis， treatment and prognosis of gastric neuroendocrine neoplasms 　　LI Xiaojing 　　Department of Internal Medicine， Central Hospital of Zibo Mining Refco Group Ltd， Zibo 255120， China 　　[Abstract] Objective To investigate the diagnosis， treatment and prognosis of gastric neuroendocrine tumors （neuroendoerine neoplasms gastric， GNENs）. Methods The clinical and pathological data of 26 patients with gastric neuroendocrine tumors diagnosed from March 2005 to March 2015 were retrospectively analyzed. Results 26 cases of patients with newly diagnosed multiple manifestations were abdominal pain and discomfort， dizziness， nausea， diarrhea， hematochezia， underwent gastroscopy and biopsy. Clinical Ⅰ type 12 cases， the lesions were polyp type or uplift， located in 7 cases of gastric body， 5 cases of gastric fundus， pathological grading were grade G1， the average diameter of lesions 1.5 cm. Clinical Ⅱ type 5 cases， the lesions were polyp type or bulge type， 2 cases of gastric fundus， 2 cases of gastric body， 1 case of gastric antrum， average diameter of 2 cm； G1 grade 4 cases； G2 grade 1 case， with 3 cases of gastric ulcer. Clinical type Ⅲ in 7 cases， 3 cases of polyp type， 4 cases of ulcer type， the average diameter of 4 cm， 3 cases of gastric fundus， 3 cases of gastric body， 1 case of gastric sinus， G2 grade 5 cases， G3 grade