Clinicopathological features of gastrointestinal neuroendocrine neoplasms at grades G1/G2: 94 cases

Objective To explore the clinicopathological features of gastrointestinal neuroendocrine neoplasms (GI-NENs) at grades G1/G2 on overall survival (OS) and disease-free survival (DFS). Methods A total of 94 patients of GI-NENs patients at grades G1/G2 who were admitted to Yixing Hospital Affiliated to Jiangsu University between January 2011 to December 2020 were enrolled and their clinicopathological and follow-up data were retrospectively analyzed. Survival analysis was performed by Kaplan-Meier method and the Cox proportional hazards model was used for investigating OS and DFS. Results Among the 94 patients, there were 45 (47.9%) men with an average age of (55.32±13.19) years. The mean lesion diameter was (0.84±0.80) cm. There were 84 cases with complete tumor resection (R0). Furthermore, 40 (42.6%) cases were chromogranin A (CgA)-positive, 93 (98.9%) cases were synapsin (Syn)-positive, 27 (28.7%) cases were neuron-specific enolase (NSE)-positive and the mean Ki-67 index was (2.53±2.34)%. Moreover, 83 cases (88.3%) were at grade G1, and 11 cases (11.7%) were at grade G2. The median follow-up time was 45 (10-131) months. Kaplan-Meier analysis showed that lower WHO pathological grade and stage, tumor diameter <1 cm, relatively young age and CgA-negative patients had better OS and DFS (both P<0.05), while positive margin, transendoscopic trap electrocoagulation and multiple tumors were associated with shorter DFS (P<0.05). According to the multivariate analysis of the Cox proportional hazards model, resection margin and tumor diameter were independent prognostic factors associated with DFS. Conclusions Tumor diameter, margin, and CgA are associated with the prognosis of GI-NENs patients. Appropriate therapeutic strategies should be developed for patients with different tumor sizes, sites, WHO grades and stages.