【摘要】 目的探索Ⅳ型胃神经内分泌肿瘤(G-NENs)的临床病理特征及影响术后复发的危险因素。方法根据2010年世界卫生组织提出的G-NENs病理分级标准,将69例Ⅳ型G-NENs患者分为胃神经内分泌癌组(G-NEC)、胃混合性腺神经内分泌癌组(G-MANEC)。分析其临床病理特征及影响术后复发的危险因素。结果Ⅳ型G-NENs以中老年男性多见,首诊症状不典型。G-NEC与G-MANEC的临床病理特征差异无统计学意义(P>0.05)。G-MANEC组较G-NEC组术后不易复发,行辅助化疗的患者预后均较未化疗者好。Ⅳ型G-NENs、G-MANEC患者使用依托泊苷+顺铂(EP)方案或奥沙利铂+替吉奥(SOX)方案行辅助化疗对术后复发的影响无统计学意义(P>0.05)。结论Ⅳ型G-NENs患者的临床表现不典型。G-NEC与G-MANEC的临床病理特征相似。G-MANEC患者较G-NEC患者预后好,辅助化疗可以改善Ⅳ型G-NENs患者的预后,使用EP或SOX方案行辅助化疗对Ⅳ型G-NENs、G-MANEC患者预后的影响无明显差异。更多还原

【Abstract】 Objective To explore the clinicopathological characteristics and the risk factors in postoperative recurrence of type Ⅳ G-NENs. Methods According to G-NENs pathological grading standard proposed by World Health Organization in 2010, 69 patients with type Ⅳ G-NENs were divided into G-NEC group and G-MANEC group. The clinicopathological characteristics and risk factors affecting postoperative recurrence of these two groups were analyzed. Results Type Ⅳ G-NENs were more common in middle-aged and old men, and the symptoms at the first diagnosis were not typical. There was no statistically significant difference in the clinicopathological characteristics between G-NEC and G-MANEC group(P>0.05). G-MANEC group was less prone to recurrence after operation than G-NEC group, and the patients with adjuvant chemotherapy had better prognosis than those without chemotherapy. In patients with type Ⅳ G-NENs and G-MANEC, the use of EP regimen or SOX regimen for adjuvant chemotherapy had no statistically significant effect on postoperative recurrence(P>0.05). Conclusion The clinical manifestations of patients with type Ⅳ G-NENs are not typical. The clinicopathological characteristics of G-NEC and G-MANEC are similar. G-MANEC patients have better prognosis than G-NEC patients. Adjuvant chemotherapy can improve the prognosis of patients with type Ⅳ G-NENs. The effects of adjuvant chemotherapy using EP or SOX regimen have no significant difference in the prognosis of patients with type Ⅳ G-NENs and G-MANEC.更多还原