Objective: To analyse the clinical spectrum and endoscopic treatment outcome of patients diagnosed with gastrointestinal carcinoid tumours.
Study design: Case series.
Place and duration of study: The First Hospital of Putian City of Fujian Province, China from 2012 to 2019.
Methodology: Patients with gastrointestinal carcinoid tumours were searched on the gastrointestinal endoscopic database and the hospital medical records database. Patients who were evaluated and treated at other institutions or with insufficient clinical information were excluded. Data were extracted from the databases, including clinical presentation, tumour size and location, treatment, complications of treatment, and clinical and endoscopic follow-up.
Results: In 113 cases, 92 tumours were smaller than 1 cm, 16 tumours were between 1-2 cm, and 5 tumours were larger than 2 cm in size. Ninety-five (84.1%) tumours showed as nodules with smooth surface, and 4(3.5%) as neoplasms with malignant performance. The tumours were limited to the mucosa in 14 (12.4%) cases, invaded into the submucosa in 88 (77.9%) cases, and the muscularis propria in 6 cases (5.3%). Most of the tumours (87.6%) were located in the rectum. The Ki-67 index was more than 30% in cases with metastases. One hundred and eight (95.6%) gastrointestinal carcinoid tumour patients were treated with endoscopic resection including endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), and 5 (4.4%) patients underwent surgical resection. All 108 patients including the 6 patients with positive margins had no relapse of carcinoid tumour on follow-up.
Conclusion: The rectum may be the most common location of gastrointestinal carcinoid tumours in Asian people. Most small tumours located in the stomach, colon, and rectum are nonfunctional, especially in rectum. Endoscopic excision including EMR and ESD is effective and safe for the treatment of small-sized gastrointestinal carcinoid tumours. Ki-67 index can be a good predictor for malignant potency of gastrointestinal carcinoid tumours.
Key words: Gastrointestinal carcinoid tumours, Neuroendocrine tumour, Clinical features, Endoscopic treatment.