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Surgical Endoscopy

, Volume 31, Issue 10, pp 3864–3871 | Cite as

Clinical characteristics, risk factors and outcomes of asymptomatic rectal neuroendocrine tumors

  • Sun-Hye Ko
  • Myong Ki BaegEmail author
  • Seung Yeon Ko
  • Hee Sun Jung
Article

Abstract

Background

Rectal neuroendocrine tumors (NET) are often asymptomatic and frequently discovered during health examinations. However, data on the risk factors of asymptomatic rectal NETs are lacking. We investigated the risk factors, clinical characteristics and outcomes of asymptomatic rectal NETs discovered during health screening.

Materials and methods

Asymptomatic subjects who underwent colonoscopy during routine health screening at a tertiary hospital from March 2009 to July 2014 were reviewed. Subjects with histologically confirmed rectal NETs were compared with healthy controls from the same population. Risk factors for rectal NETs were analyzed by multivariable analysis. Clinical outcomes of the resected NETs were also analyzed.

Results

A total of 21,706 Subjects underwent screening colonoscopy during the study period. 3417 were excluded from the study, and 180 rectal NET subjects were compared with 18,109 controls. Multivariable analysis showed that a previous history of malignancy (OR 2.960, 95% CI 1.673–5.237, p < 0.001), hypertriglyceridemia (OR 1.482, 95% CI 1.046–2.100, p = 0.027), higher fasting plasma glucose levels (OR 1.008, 95% CI 1.003–1.014, p = 0.001) and higher carcinoembryonic antigen levels (OR 1.019, 95% CI 1.003–1.035, p = 0.021) were significant risk factors while older age (OR 0.964, 95% CI 0.951–0.977, p < 0.001) was a preventive factor. One hundred and sixty nine subjects had endoscopic resection, five were treated by local surgery and six by radical surgery. Complete resection was achieved in 152 subjects. There were three cases of positive lymph nodes and one metastasis. Histology revealed four lymphatic, five vascular and two cases of perineural invasion. One hundred and fifty seven subjects were followed up for at least 1 year (median 38.6 months, 12–84 months). There were no recurrences during the follow-up period.

Conclusions

Younger age, previous history of malignancy, higher fasting plasma glucose levels and hypertriglyceridemia are significantly associated with rectal NET risk.

Keywords

Rectal neuroendocrine tumor Screening colonoscopy Health screening Risk factor Outcome 

Notes

Acknowledgements

This work was supported through the research fund of Catholic Kwandong University, International St. Mary’s Hospital.

Compliance with ethical standards

Disclosure

Drs Sun-Hye Ko, Myong Ki Baeg, Seung Yeon Ko and Hee Sun Jung have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of Internal Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  2. 2.Division of Gastroenterology, Department of Internal Medicine, International St. Mary’s Hospital, College of MedicineCatholic Kwandong UniversitySeo-guSouth Korea
  3. 3.Department of Surgery, Incheon St. Mary’s Hospital, College of MedicineCatholic University of KoreaIncheonSouth Korea
  4. 4.Department of Health Promotion, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea

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