Abstract
PurposeThe detection rate of colorectal neuroendocrine tumours (CR-NETs) is increasing, but their treatment is still controversial. Lymph node metastasis is an important reference index for the selection of treatment. The aim of our study was to investigate the factors associated with lymph node metastasis and prognosis of CR-NETs.MethodsThe case characteristics of patients with colorectal neuroendocrine tumours from January 2011 to December 2020 were retrospectively analysed, including age, gender, tumour size, tumour location, lymph node metastasis, pathological grade and follow-up.ResultsA total of 195 cases of CR-NETs were included in this study. When 15 mm was used as the cut-off value, the sensitivity, specificity and area under the curve (AUC) of lymph node metastases were 95.9%, 95.2% and 0.986, respectively. Multivariate analysis suggested that tumour size ≥ 15 mm (OR: 30.517, 95% CI: 1.250 ~ 744.996, p = 0.036) and lymphovascular invasion (OR: 42.796, 95% CI: 2.882 ~ 635.571, p = 0.006) were independent risk factors for lymph node metastasis. Age ≥ 56 (HR: 7.434, 95% CI: 1.334 ~ 41.443, p = 0.022) and distant metastasis (HR: 24.487, 95% CI: 5.357 ~ 111.940, p < 0.001) were independent prognostic factors in multivariable analyses.ConclusionsWhen the size of a CR-NET is ≥ 15 mm, the risk of lymph node metastasis is higher, and it is recommended to choose the surgical method carefully. Tumour size and lymphovascular invasion were independent risk factors for lymph node metastasis. Age ≥ 56 and distant metastasis were independent prognostic factors.
Highlights
Neuroendocrine tumours (NETs) are a kind of tumour with neuroendocrine function and malignant potential
We examined the value of tumour size on the risk for lymph node metastasis and the factors associated with prognosis of colorectal neuroendocrine tumours (CR-NETs)
A total of 195 cases of CR-NETs were included in this study, including 31 cases of colon tumour and 164 cases of rectum tumour
Summary
Neuroendocrine tumours (NETs) are a kind of tumour with neuroendocrine function and malignant potential. It originates from pheochromo-like cells and has obvious heterogeneity [1]. With the use of colonoscopy, the detection rate of colorectal neuroendocrine tumours (CR-NETs) is increasing [2]. The associated risk factors are unknown; a study from Japan has shown higher levels of serum cholesterol and ferritin, metabolic syndrome and family history of cancer as factors that may explain the increasing incidence and prevalence of rectal NET [3]. Tumour sites vary by race, with the incidence of rectal NETs in the Asian population increasing from 0.2 per 100,000 in 1973 to 0.86 per 100,000 in 2004, which is significantly higher than that in the white population [4]. The incidence of CR-NETs is the fastest increasing among all NETs, accounting for 32.6% of all NETs and becoming the second most common NET in China [5]
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