直肠神经内分泌肿瘤淋巴结转移的危险因素分析及内镜切除方式比较

郑秀丽; 姚志原; 吴明利; 尔丽绵; 李胜棉

doi:10.19401/j.cnki.1007-3639.2022.09.007

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直肠神经内分泌肿瘤淋巴结转移的危险因素分析及内镜切除方式比较

专题论著 | 更新时间：2025-12-31

- 直肠神经内分泌肿瘤淋巴结转移的危险因素分析及内镜切除方式比较
- Analysis of risk factors of lymph node metastasis and comparison of endoscopic resection methods in rectal neuroendocrine neoplasm
- 中国癌症杂志 2022年32卷第9期页码：800-806
- 作者机构：
  
  1. 河北医科大学第四医院内镜科,河北石家庄 050035
  2. 河北医科大学第四医院消化内科,河北石家庄 050035
- 作者简介：
  
  [ "郑秀丽（ORCID: 0000-0001-9423-231X）,博士,主治医师。" ]
  [ "李胜棉,河北医科大学第四医院消化内科主任医师,教授,博士研究生导师。中国抗癌协会老年肿瘤专业委员会常务委员,亚太医学生物免疫学会肝病分会常务委员,中国临床肿瘤学会结直肠癌专家委员会委员,中国抗癌协会肿瘤支持治疗专业委员会委员,中国抗癌协会化疗专业委员会委员,中国医疗保健国际交流促进会消化道肿瘤多学科分会委员,中国中西医结合学会肝病学分会委员,河北省抗癌协会老年肿瘤专业委员会主任委员,河北省预防医学会消化疾病防控专业委员会主任委员,河北省女医师协会消化专业委员会主任委员。" ]
- 基金信息：
  
  白求恩·肿瘤基础研究计划(BCF-NH-ZL-20201119-007)
- DOI：10.19401/j.cnki.1007-3639.2022.09.007
  中图分类号： R735.3+7
- 收稿：2022-06-20，
  
  修回：2022-09-01，
  
  纸质出版：2022-09-30
- 稿件说明：
移动端阅览
郑秀丽, 姚志原, 吴明利, 等. 直肠神经内分泌肿瘤淋巴结转移的危险因素分析及内镜切除方式比较[J]. 中国癌症杂志, 2022,32(9):800-806.

Xiuli ZHENG, Zhiyuan YAO, Mingli WU, et al. Analysis of risk factors of lymph node metastasis and comparison of endoscopic resection methods in rectal neuroendocrine neoplasm[J]. China Oncology, 2022, 32(9): 800-806.
郑秀丽, 姚志原, 吴明利, 等. 直肠神经内分泌肿瘤淋巴结转移的危险因素分析及内镜切除方式比较[J]. 中国癌症杂志, 2022,32(9):800-806. DOI： 10.19401/j.cnki.1007-3639.2022.09.007.

Xiuli ZHENG, Zhiyuan YAO, Mingli WU, et al. Analysis of risk factors of lymph node metastasis and comparison of endoscopic resection methods in rectal neuroendocrine neoplasm[J]. China Oncology, 2022, 32(9): 800-806. DOI： 10.19401/j.cnki.1007-3639.2022.09.007.

摘要

背景与目的：

直肠神经内分泌肿瘤（rectal neuroendocrine neoplasm

R-NEN）的发病率呈上升趋势

但其治疗仍存在争议

特别是10 ~ 20 mm之间的肿瘤。本研究通过分析R-NEN的临床病理学特征

探讨其淋巴结转移的危险因素

并比较不同内镜切除效果的差异

探索内镜治疗R-NEN的适应证及方式。

方法：

回顾性分析2007年2月

#x02014;2020年12月河北医科大学第四医院收治的R-NEN患者的相关临床信息

分析淋巴结转移的危险因素

比较不同内镜切除方式的安全性和有效性。

结果：

共分析了190例R-NEN患者的临床病理学特征

结果显示

肿瘤大小

#x02265;12.5 mm（OR = 69.081

95% CI：11.385 ~ 419.155

0.001）和淋巴管血管侵犯（OR = 11.732

95% CI：1.028 ~ 84.567

= 0.015）是淋巴结转移的独立危险因素。比较内镜下套帽辅助黏膜切除术（endoscopic mucosal resection with cap

EMR-c）和内镜下黏膜下剥离术（endoscopic submucosal dissection

ESD）治疗114例R-NEN患者的临床资料

结果显示

EMR-c组的手术时间明显短于ESD组[（10.23

#x000b1;1.99）min

（24.78

#x000b1;8.09）min

0.001

]

。两组的内镜整块切除率、病理学完全切除率和并发症发生率差异无统计学意义（

0.05）。

结论：

肿瘤大小

#x02265;12.5 mm和淋巴管血管侵犯是R-NEN患者淋巴结转移的独立危险因素。对于

12.5 mm且无淋巴结转移的R-NEN来说

EMR-c和ESD均是安全有效的治疗方法。

Abstract

Background and purpose:

In recent years

the incidence of rectal neuro

endocrine neoplasm (R-NEN) has been on the rise. However

its treatment remains controversial

especially for tumors of 10-20 mm in diameter. In this study

the clinicopathological characteristics of R-NEN were analyzed

the risk factors for lymph node metastasis were discussed

and the effects of different endoscopic resection were compared

so as to ascertain the indications and methods of endoscopic treatment of R-NEN.

Methods:

Clinical data of patients with R-NEN treated in the Fourth Hospital of Hebei Medical University from February 2007 to December 2020 were collected and retrospectively analyzed. The risk factors of lymph node metastasis were analyzed

and the safety and effectiveness of different endoscopic resection methods were compared.

Results:

The clinicopathological features of 190 patients with R-NEN were analyzed

suggesting that tumor size

#x02265;12.5 mm (OR = 69.081

95% CI: 11.385-419.155

0.001) and lymphovascular invasion (OR = 11.732

95% CI: 1.028-84.567

= 0.015) were independent risk factors for lymph node metastasis. The clinical data of 114 patients with R-NEN treated with endoscopic mucosal resection with cap (EMR-c) and endoscopic submucosal dissection (ESD) respectively were compared. The results showed that the duration of operation was significantly shorter in EMR-c group than in ESD group [(10.23

#x000b1;1.99) min

(24.78

#x000b1;8.09) min

0.001

]

. There was no significant difference in rate of endoscopic en bloc resection

pathological complete resection rate and complication rate between the two groups (

0.05).

Conclusion:

Tumor size

#x02265;12.5 mm in diameter and presence of lymphovascular invasion are independent risk factors for lymph node metastasis in patients with R-NEN. Both EMR-c and ESD are safe and effective treatments for R-NEN of

12.5 mm in diameter and without lymph node metastasis.

关键词

Keywords

references

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