Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2024; 16(3): 907-918
Published online Mar 15, 2024. doi: 10.4251/wjgo.v16.i3.907
Clinical features and prognostic factors of duodenal neuroendocrine tumours: A comparative study of ampullary and nonampullary regions
Sa Fang, Yu-Peng Shi, Lu Wang, Shuang Han, Yong-Quan Shi
Sa Fang, Yu-Peng Shi, Shuang Han, Department of Gastroenterology, Honghui Hospital, Xi’an Jiaotong University, Xi'an 710054, Shanxi Province, China
Lu Wang, Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710032, Shaanxi Province, China
Yong-Quan Shi, Department of Gastroenterology, Xijing Hospital Affiliated to Air Force Medical University, Xi'an 710032, Shaanxi Province, China
Co-first authors: Sa Fang and Yu-Peng Shi.
Co-corresponding authors: Yong-Quan Shi and Shuang Han.
Author contributions: Fang S contributed to data collection, statistical analysis, follow-up visit, writing-original draft, and writing-review and editing; Wang L, Shi YP, Han S and Shi YQ contributed to writing-review and editing.
Institutional review board statement: The study protocol was approved by the Clinical Research Ethics Committee of Honghui Hospital, Xi’an Jiaotong University (No. 202401004).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at [email address: hexie19901121@163.com]. Participants gave informed consent for data sharing. No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Quan Shi, PhD, Chief Doctor, Department of Gastroenterology, Xijing Hospital Affiliated to Air Force Medical University, No. 127 Changle East Road, Xincheng District, Xi'an 710032, Shaanxi Province, China. shiyquan@fmmu.edu.cn
Received: December 2, 2023
Peer-review started: December 2, 2023
First decision: December 14, 2023
Revised: January 5, 2024
Accepted: January 29, 2024
Article in press: January 29, 2024
Published online: March 15, 2024
Processing time: 101 Days and 6.8 Hours
ARTICLE HIGHLIGHTS
Research background

Duodenal neuroendocrine tumours (DNETs) are rare neoplasms. However, the incidence of DNETs has been increasing in recent years, especially as an incidental finding during endoscopic studies. Regrettably, there is no consensus regarding the ideal treatment of DNETs. Even there are few studies on the clinical features and survival analysis of DNETs. Some studies suggest that the prognosis of DNETs is related to the tumour region (ampullary/nonampullary), function, classification and grading, staging, treatment, etc. However, there are no articles that comprehensively analyse the impact of these factors on the survival of DNETs. Due to the rarity of DNETs and insufficient knowledge of their natural history, their disease characteristics and prognostic factors are currently not well understood. At present, there are few prognostic analysis data on DNETs in China.

Research motivation

This study, as the first clinical study on DNETs in China, can provide some reference for the prevention and treatment of this disease.

Research objectives

This study comprehensively analyses the basic characteristics, clinical symptoms, tumour characteristics, histological grading and classification, tumour clinical staging, treatment, and factors affecting the survival prognosis of patients with DNETs. We found that surgical treatment is a protective factor for prolonging the survival of DNET patients. Compared to DNETs in the ampullary region, patients in the nonampullary region had a longer survival period. The liver is the organ most susceptible to distant metastasis of nonampullary DNETs.

Research methods

A retrospective study of the clinical features and prognostic factors of the ampullary and nonampullary of the duodenum neuroendocrine tumours. Compare the clinical characteristics of patients with ampullary and nonampullary DNETs, and analyze the prognostic factors affecting DNETs. Further research will be conducted on the clinical characteristics and prognosis of nonampullary DNETs. In this study, a Cox regression model was used to analyse prognostic risk factors.

Research results

Twenty-nine DNET patients were screened. The male to female ratio was 1:1.9, and females comprised the majority. When diagnosed, the clinical symptoms of the ampullary region group were mainly abdominal pain (85.7%), while those of the nonampullary region groups were mainly abdominal distension (59.1%). The survival time of the ampullary region group was shorter than that of the nonampullary region group (P < 0.000). Multivariate analysis showed that tumours in the ampulla region and no surgical treatment after diagnosis were independent risk factors for the survival of DNET patients. Further analysis of nonampullary DNET patients showed that the survival time of patients with a tumour diameter < 2 cm was longer than that of patients with a tumour diameter ≥ 2 cm (t = 7.243, P = 0.048). This study, as the first clinical study on DNETs in China, can provide some reference for the prevention and treatment of this disease. However, the design of a single centre retrospective study has a limited sample source, and it is difficult to fully reflect the characteristics of the disease. Therefore, large-scale, multicentre research is still needed to further explore the characteristics and risk factors for this disease and provide the best diagnosis and treatment strategies for DNET patients.

Research conclusions

In this study, Compare the clinical characteristics of patients with ampullary and nonampullary DNETs, and analyze the prognostic factors affecting DNETs. A Cox regression model was used to analyse prognostic risk factors. Multivariate analysis showed that whether surgery was performed, as well as the location of the tumour (ampullary/nonampullary), affected the overall survival rate of DNET patients, suggesting that surgical treatment is a protective factor for prolonging the survival period of DNET patients.

Research perspectives

Due to the high probability of metastasis in nonampullary DNETs with a diameter of 1-2 cm, there is still controversy over whether to perform endoscopic resection or surgical resection. For this group of patients, further research is needed to determine the optimal treatment plan.