For the histopathological work-up of resected neuroendocrine tumors of the small intestine (siNET), the determination of lymphatic (LI), microvascular (VI) and perineural (PnI) invasion is recommended. Their association with poorer prognosis has already been demonstrated in many tumor entities. However, the influence of LI, VI and PnI in siNET has not been sufficiently described yet. A retrospective analysis of all patients treated for siNET at the ENETS Center of Excellence Charité–Universitätsmedizin Berlin, from 2010 to 2020 was performed (n= 510). Patients who did not undergo primary resection or had G3 tumors were excluded. In the entire cohort (n= 161), patients with LI, VI and PnI status had more distant metastases (48.0% vs. 71.4%,p= 0.005; 47.1% vs. 84.4%,p< 0.001; 34.2% vs. 84.7%,p< 0.001) and had lower rates of curative surgery (58.0% vs. 21.0%,p< 0.001; 48.3% vs. 16.7%,p< 0.001; 68.4% vs. 14.3%,p< 0.001). Progression-free survival was significantly reduced in patients with LI, VI or PnI compared to patients without. This was also demonstrated in patients who underwent curative surgery. Lymphatic, vascular and perineural invasion were associated with disease progression and recurrence in patients with siNET, and these should therefore be included in postoperative treatment considerations.
在小肠神经内分泌肿瘤（siNET）切除标本的病理学评估中，建议对淋巴管侵犯（LI）、微血管侵犯（VI）和神经周围侵犯（PnI）进行判定。这些指标与不良预后的关联已在多种肿瘤类型中得到证实。然而，LI、VI和PnI在siNET中的影响尚未得到充分阐述。本研究对2010年至2020年间在柏林夏里特医学院ENETS卓越中心接受治疗的所有siNET患者（n=510）进行回顾性分析。排除未接受原发灶切除或G3级肿瘤患者后，最终队列（n=161）中，存在LI、VI和PnI的患者具有更高的远处转移率（48.0% vs. 71.4%，p=0.005；47.1% vs. 84.4%，p<0.001；34.2% vs. 84.7%，p<0.001）和更低的根治性手术率（58.0% vs. 21.0%，p<0.001；48.3% vs. 16.7%，p<0.001；68.4% vs. 14.3%，p<0.001）。与无侵犯患者相比，存在LI、VI或PnI的患者无进展生存期显著缩短，这一现象在接受根治性手术的患者群体中同样得到验证。淋巴管、血管及神经周围侵犯与siNET患者的疾病进展和复发密切相关，因此应在术后治疗决策中纳入考量。
肿瘤(癌症)患者之家