小肠神经内分泌肿瘤:与小肠腺癌相比,其特征独特,致死率低

IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Gastroenterology and Hepatology Pub Date : 2024-09-17 DOI:10.1111/jgh.16740
Zhen Yang, Haibin Xu, Luan Li, Kaiming Leng, Guangjun Shi
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引用次数: 0

摘要

背景和目的基于人群的研究比较美国小肠腺癌(SBA)和小肠神经内分泌肿瘤(SBNET)患者的临床特征和生存差异的研究非常有限。方法分析了2000年至2018年期间从监测、流行病学和最终结果数据库中获得的SBA或SBNET患者的数据。结果2000年至2018年期间,经年龄调整的SBA发病率略有上升,而SBNET的发病率则显著上升,成为小肠癌(SBC)的主要亚型。SBA和SBNET的诊断高峰分别为65-69岁和60-64岁,后者的年龄特异性发病率更高,性别分布保持平衡。临床病理学差异显示,SBA偏好十二指肠、肿瘤体积较大、处于晚期,而SBNETs则偏好回肠、处于早期、疗效较好。与 SBA 患者相比,SBNET 患者接受手术的频率更高,但接受化疗和放疗的次数更少。与 SBNETs 诊断密切相关的因素包括女性性别、白种人、高龄、婚姻状况、近期诊断、肿瘤分化程度高、体积较小、远端位置和早期表现。生存分析显示,SBNET 的死亡率比 SBA 显著降低了 79%。亚组分析进一步证实了SBNETs始终具有良好的生存优势,突出了组织学分类在预后判断中的临床意义。结论与SBA相比,SBNETs表现出独特的临床病理特征,其特点是更倾向于低分化和早期表现,从而有助于获得更好的生存结果。
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Small bowel neuroendocrine tumors: Unique features and low lethality compared with small bowel adenocarcinoma
Background and AimPopulation‐based studies comparing clinical characteristics and survival disparities between patients with small bowel adenocarcinoma (SBA) and small bowel neuroendocrine tumors (SBNETs) in the United States are limited.MethodsData for patients with SBA or SBNETs, obtained from the Surveillance, Epidemiology, and End Results database for the years between 2000 and 2018 were analyzed.ResultsBetween 2000 and 2018, the age‐adjusted incidence of SBA experienced a marginal increase whereas SBNETs demonstrated a significant increase, emerging as the predominant subtype of small bowel cancer (SBC). Diagnoses peaked at ages 65–69 years for SBA and 60–64 years for SBNETs, with the latter exhibiting a heightened age‐specific incidence and maintaining equilibrium in gender distribution. Clinicopathologic disparities revealed SBA's duodenal predilection, larger tumor size, and advanced stages, contrasting with SBNETs' ileal predilection, early‐stage presentation, and superior outcomes. SBNETs patients underwent surgery more frequently but received less chemotherapy and radiation than SBA patients. Factors intricately correlated with a diagnosis of SBNETs included female gender, White race, advanced age, marital status, recent diagnoses, superior tumor differentiation, smaller size, distal location, and early‐stage presentation. Survival analysis unveiled a remarkable 79% reduction in the mortality risk for SBNETs compared with SBA. Subgroup analysis further confirmed the consistently favorable survival advantages of SBNETs, highlighting the clinical relevance of histological classification in prognostication.ConclusionCompared with SBA, SBNETs exhibited distinctive clinicopathological features characterized by a higher inclination toward low‐grade and early‐stage manifestations, thereby contributing to superior survival outcomes.
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来源期刊
CiteScore
7.90
自引率
2.40%
发文量
326
审稿时长
2.3 months
期刊介绍: Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.
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