Clinicopathological Features and Prognosis of Gastroenteropancreatic Neuroendocrine Tumors: Analysis from a Single-institution

Abstract

Background: The gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) is the most common type of neuroendocrine neoplasm. We summarized data in our centre to investigate the clinicopathological features, diagnostic methods, therapeutic approaches and prognosis for this neoplasm to increase knowledge of this disease in Asian populations. Method: A total of 122 patients treated at Sun Yet-san Memorial Hospital of Sun Yat-sen University between January 2000 and December 2011 were analyzed retrospectively. Results: Pancreas was the most common site of involvement (65/122, 53.3%); this disease has no special symptoms; positive rates of chromogranin A (CgA) and synaptophysin (Syn) were 81.1% and 87.7%, respectively. The positive rate of Syn had statistical difference among the three grades, but not CgA. Some 68 patients had G1 tumors, 32 G2 tumors and 22 G3 tumors, and Chi-square test showed that higher grading was correlated with worse prognosis (χ 2 =32.825, P=0.0001). A total of 32 patients presented with distant metastasis, and 8 cases emerged during following up. Cox proportional hazards regression modeling showed that the tumor grade (P=0.01), lymphatic metastasis (P=0.025) and distant metastasis (P=0.031) were predictors of unfavorable prognosis. The overall 5-year survival rate was 39.6%, the 5-year survival rate of G1 was 55.7%, and the G2 and G3 were 34.2% and 0%, respectively.Conclusions: The incidence of gastroenteropancreatic neuroendocrine tumors has risen over the last 12 years. All grades of these diseases metastasize readily, and further research regarding the treatment of patients after radical surgery is needed to prolong disease-free survival.

Computer Tomography and Magnetic Resonance Image Manifestations of Primary Hepatic Neuroendocrine Cell Carcinomas

“…Neuroendocrine cell carcinoma often occurred from the bronchi, gastrointestinal tract, pancreas and other parts, occasionally was seen in the prostate, retroperitoneal, gall bladder, uterus, etc. (Pilichowska et al, 1999;Modlin et al, 2008;Yao et al, 2008;Zeng et al, 2013). Liver neuroendocrine carcinoma found in clinical mostly induced by the intestines and pancreas transfer, PHNEC was very rare originating in the liver (Pilichowska et al, 1999;Tohyama et al, 2005;Hamanaka et al, 2012;Yalav et al, 2012), accounting for 1%-5% of all liver cancer, and 0.8% -4.0% of systemic neuroendocrine tumors, the imaging findings were lack of specificity, leading to difficultly preoperative diagnosis (Pilichowska et al, 1999;Bader et al, 2001;Tohyama et al, 2005;Ulusan et al, 2005;Krohn et al, 2011;Yalav et al, 2012;Baek et al, 2013).…”

“…Comprehensive inspection was performed at the same time. A total of 122 patients with gastroenteropancreatic neuroendocrine neoplasm were analyzed retrospectively (Zeng et al, 2013), and the results showed that 32 patients showed distant metastases, of which 29 cases (90.7%)had liver metastasis. It is necessary to perform the physical examination in the diagnosis of primary hepatic neuroendocrine cell carcinoma.Exception of extrahepatic primary lesions, especially the primary lesion of pancreas and intestinal tract , it is also helpful that postoperative clinical follow-up and auxiliary examination to discover potential primary lesionsl.…”

“…The clinical hepatic neuroendocrine tumors mostly was induced by the transfer of intestines and pancreas and others (Pilichowska et al, 1999;Solcia et al, 2000;Modlin et al, 2008;Schwartz et al, 2008;Yao et al, 2008;Zeng et al, 2013) with the histopathologic performance of organ-like growth pattern, the tumor cells was argyrophilic, so they had specific positive performance in the detection of chromogranin A (CgA) and synaptophysin (Syn) of immunohistochemistry (Chang et al, 2007;Huang et al, 2010;Kim et al, 2011;Park et al, 2012). Primarily hepatic neuroendocrine carcinoma (PHNEC) was very rare, accounting for 1-5% of primary liver tumors, and 0.8%-4.0% of systemic neuroendocrine tumors (Pilichowska et al, 1999;Solcia et al, 2000;Yao et al, 2008;Huang et al, 2010).…”

Analysis on the Characteristics and Prognosis of Pulmonary Neuroendocrine Tumors

“…Pulmonary NET could be clinically, radiologically, and pathologically classified into four subtypes: TC, AC, LCNEC and SCLC (Haghighi et al, 2012;Liu et al, 2013;Yucel et al, 2013;Zahir et al, 2013;Zeng et al, 2013). They represent a specific group of tumors with heterogeneous histological patterns and clinical behaviors.…”

Somatostatin Analogues Do Not Prevent Carcinoid Crisis

“…Neuroendocrine tumors (NETs) are a group of heterogeneous tumors that originate from neuroendocrine cells throughout the body (Zeng et al, 2013). Recently, NETs have drawn much attention due to the rapidly rising incidence and relatively benign prognosis (Yao et al, 2008).…”