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胰腺高分化或低分化无功能性神经内分泌癌：单中心17例经验

Well or poorly differentiated nonfunctioning neuroendocrine carcinoma of the pancreas: a single institution experience with 17 cases.

作者信息

Sellner F, Sobhian B, De Santis M, Pont J, Staettner St, Sellner St, Karner J, Klimpfinger M

机构信息

Department of Surgery, Kaiser-Franz-Josef-Hospital, Vienna, Austria.

出版信息

Eur J Surg Oncol. 2008 Feb;34(2):191-5. doi: 10.1016/j.ejso.2007.03.008. Epub 2007 May 1.

DOI:10.1016/j.ejso.2007.03.008
PMID:17475440
Abstract

AIM

To evaluate the influence of distinguishing between well and poorly differentiated nonfunctioning neuroendocrine pancreatic carcinomas (PC).

METHOD

Six well differentiated and 11 poorly differentiated nonfunctioning neuroendocrine PC were retrospectively analyzed for differences and compared with 340 ductal PC.

RESULTS

  1. There was no difference in pT categories between well differentiated and, poorly differentiated nonfunctioning neuroendocrine PC and ductal PC. 2. The rate of the pN1 category was lower in well differentiated lesions (20%) than in poorly differentiated lesions (66%) and in the ductal PC group (75%). 3. The outcome of patients with R0 resections was significantly better for well differentiated neuroendocrine PC with all patients alive than for poorly differentiated ones and for ductal PC (5-year survival rate 0% and 18%, respectively). 4. The outcome following R1/R2 resections for poorly differentiated neuroendocrine PC tended to be similar than for ductal PC (1-year survival rate 20% vs. 33%). 5. There was no difference in mean survival time (9 months) between poorly differentiated lesions and ductal PC after palliative procedures.

CONCLUSIONS

The better outcome of surgical treatment of nonfunctioning neuroendocrine PC vs. that of ductal PC was confined to well differentiated neuroendocrine lesions. For poorly differentiated lesions the outcome was as poor as for ductal PC. These results underscore the importance to distinguish between well and poorly differentiated nonfunctioning neuroendocrine PC.

摘要

目的

评估鉴别高分化与低分化无功能性胰腺神经内分泌癌（PC）的影响。

方法

回顾性分析6例高分化和11例低分化无功能性神经内分泌PC的差异，并与340例导管PC进行比较。

结果

  1. 高分化与低分化无功能性神经内分泌PC以及导管PC之间的pT分类无差异。2. 高分化病变的pN1分类率（20%）低于低分化病变（66%）和导管PC组（75%）。3. R0切除患者中，高分化神经内分泌PC患者的预后明显更好，所有患者均存活，而低分化神经内分泌PC患者和导管PC患者的预后较差（5年生存率分别为0%和18%）。4. 低分化神经内分泌PC的R1/R2切除后的预后与导管PC相似（1年生存率分别为20%和33%）。5. 姑息治疗后，低分化病变与导管PC的平均生存时间无差异（9个月）。

结论

无功能性神经内分泌PC手术治疗的预后优于导管PC仅限于高分化神经内分泌病变。对于低分化病变，预后与导管PC一样差。这些结果强调了鉴别高分化与低分化无功能性神经内分泌PC的重要性。

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