Risk factors associated with the progression and metastases of hindgut neuroendocrine tumors: a retrospective study.
Risk factors associated with the progression and metastases of hindgut neuroendocrine tumors: a retrospective study.
复制标题
DOI：
10.1186/s12885-017-3769-4
复制
发表时间：
2017-11-16
期刊：
影响因子：
3.8
通讯作者：
Yokose T
中科院分区：
文献类型：
--
作者：
Okubo Y;Kasajima R;Suzuki M;Miyagi Y;Motohashi O;Shiozawa M;Yoshioka E;Washimi K;Kawachi K;Kameda Y;Yokose T
神经内分泌肿瘤（NETs）的全球发病率显著增加，后肠是此类肿瘤的第二大常见部位。然而，后肠NETs的进展和转移的机制尚不清楚。进行了回顾性研究，以阐明这些机制。回顾性分析1996年4月至2015年9月期间后肠NET病例的临床病理资料。排除神经内分泌癌患者。后肠NET病例的福尔马林固定石蜡包埋组织进行了详细的形态计量学和免疫组化分析。使用非参数Mann-Whitney U检验、斯皮尔曼相关系数和卡方检验进行统计分析。对数据集进行适当的多变量逻辑回归分析。考虑了五十六例后肠NET病例。微血管密度和微淋巴管密度被认为是静脉和淋巴管浸润的重要危险因素。微血管密度与肿瘤最大直径呈正相关。多因素Logistic回归分析显示，肿瘤最大直径是淋巴结转移的独立预测因子，而淋巴管浸润和MVD不是淋巴结转移的预测因子。Ki-67标记指数与年龄、性别、肿瘤最大直径、静脉浸润、淋巴管浸润、微血管密度、淋巴管密度和淋巴结转移等参数之间均无显著相关性。血管生成机制可能在后肠NET的进展中起重要作用。另外，肿瘤最大直径本身是后肠NETs淋巴结转移的独立预测因子。此外，我们的研究提出了一个问题，即在内窥镜下获得的后肠NET组织中，淋巴血管浸润的存在是否是额外手术的绝对指征。
The worldwide incidence of neuroendocrine tumors (NETs) has increased remarkably, with the hindgut being the second most common site for such tumors. However, the mechanisms underlying progression and metastasis of hindgut NETs are unclear. A retrospective study was conducted to elucidate these mechanisms. Clinicopathological data of cases of hindgut NET between April 1996 and September 2015 were analyzed, retrospectively. Patients with neuroendocrine carcinoma were excluded. Formalin-fixed paraffin-embedded tissues of hindgut NET cases were subjected to detailed morphometric and immunohistochemical analyses. Statistical analyses were performed using the non-parametric Mann-Whitney U test, Spearman’s correlation coefficient, and chi-squared test. Multivariate logistic regression analysis was conducted as appropriate for the data set. Fifty-six hindgut NET cases were considered. Microvessel density and lymphatic microvessel density were identified as significant risk factors for venous and lymphatic invasion. There was a positive correlation between microvessel density and the maximum tumor diameter. Multivariate logistic regression analysis revealed that the maximum tumor diameter alone was an independent predictor of lymph node metastasis, whereas lymphovascular invasion and MVD was not the predictor of lymph node metastasis. There were no significant correlations between the Ki-67 labeling index and any of the parameters evaluated including age, sex, the maximum tumor diameter, venous invasion, lymphatic invasion, microvessel density, lymphatic microvessel density, and lymph node metastasis. Angiogenic mechanisms may play important roles in the progression of hindgut NET. Otherwise, the maximum tumor diameter alone was an independent predictor of lymph node metastasis in hindgut NETs. Moreover, our study raises the question of whether the presence of lymphovascular invasion, in endoscopically obtained hindgut NET tissues, is an absolute indication for additional surgery or not.
登录
查看更多内容
影响因子：
3.8
作者：
Okubo Y;Nemoto T;Wakayama M;Tochigi N;Shinozaki M;Ishiwatari T;Aki K;Tsuchiya M;Aoyama H;Katsura K;Fujii T;Nishigami T;Yokose T;Ohkura Y;Shibuya K
通讯作者：
Shibuya K
影响因子：
2.6
作者：
Hackeng WM;Hruban RH;Offerhaus GJ;Brosens LA
通讯作者：
Brosens LA
影响因子：
6.2
作者：
Modlin, IM;Lye, KD;Kidd, M
通讯作者：
Kidd, M
影响因子：
2.2
作者：
Aki, Kyoko;Okubo, Yoichiro;Shibuya, Kazutoshi
通讯作者：
Shibuya, Kazutoshi
影响因子：
3.8
作者：
Okubo Y;Wakayama M;Nemoto T;Kitahara K;Nakayama H;Shibuya K;Yokose T;Yamada M;Shimodaira K;Sasai D;Ishiwatari T;Tsuchiya M;Hiruta N
通讯作者：
Hiruta N