title: [Clinical review of gastrointestinal carcinoid tumor and analysis of the factors predicting metastasis].
abstract: OBJECTIVE
  Carcinoid tumors are submucosal tumors with metastatic potential. We tried to determine the clinical course of gastrointestinal (GI) carcinoid tumors and find the factors predicting metastasis.
  
  
  METHODS
  We reviewed the clinical records of 81 cases with GI carcinoid tumors. Involved organ, age, sex, symptoms, treatments, and metastatic patterns were reviewed. We evaluated the macroscopic and microscopic parameters to predict the metastatic potential of GI carcinoid tumors.
  
  
  RESULTS
  The common sites of GI carcinoids were rectum (71.7%), stomach (13.6%), and duodenum (8.6%). Mean age of the patients was 49 years old with a peak incidence of sixth decade. Male to female ratio was 1.38:1. Most symptoms were usually nonspecific. Fifty five patients (67.9%) received endoscopic treatments while 23 patients (28.4%) received surgical treatment. Patients were followed up for a mean period of 15.6 months. There were 10 cases (12.3%) of metastasis. There were significantly more metastasis in patients with tumor size>10 mm (p<0.001), central depression or ulcer (p=0.009) in macroscopic parameter, and with invasion below submucosa, lymphatic or venous invasion, number of mitosis>2, or Ki-67 labeling index>2 in microscopic parameter (p<0.05). Independent factors predicting metastasis were tumor size and central depression or ulcer in multivariate analysis (p=0.002 and p=0.035, respectively).
  
  
  CONCLUSIONS
  Patients with tumor size>10 mm, central depression or ulcer, invasion below submucosa, lymphatic or venous invasion, mitosis>2, and Ki-67 labeling index>2 have higher metastatic potential. Those with risk factors predicting metastasis should be treated and followed carefully.
authors.affiliation: Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Jae Hyuck
authors.initials: JH
authors.lastname: Chang
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Woo Chul
authors.initials: WC
authors.lastname: Chung
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Kim
authors.forename: Chan Kwon
authors.initials: CK
authors.lastname: Jung
authors.forename: Chang Nyol
authors.initials: CN
authors.lastname: Paik
authors.forename: Jae Myung
authors.initials: JM
authors.lastname: Park
authors.forename: Yu Kyung
authors.initials: YK
authors.lastname: Cho
authors.forename: In Seok
authors.initials: IS
authors.lastname: Lee
authors.forename: Myung Gyu
authors.initials: MG
authors.lastname: Choi
authors.forename: In Sik
authors.initials: IS
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000209:etiology / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D011237:Predictive Value of Tests; D012189:Retrospective Studies