Bettini R, Boninsegna L, Mantovani W, Capelli P, Bassi C, Pederzoli P, Delle Fave G F, Panzuto F, Scarpa A, Falconi M
Department of Surgical and Gastroenterological Sciences, University of Verona, Verona, Italy.
Ann Oncol. 2008 May;19(5):903-8. doi: 10.1093/annonc/mdm552. Epub 2008 Jan 21.
Non-functioning pancreatic endocrine tumours (NF-PETs) are an aggressive gastroenteropancreatic neoplasm. The present study assessed survival, value of World Health Organisation (WHO) classification and prognostic utility of clinicopathological parameters at diagnosis.
From 1990 to 2004, 180 patients with NF-PETs were entered in a prospective database, and predictors of prognosis were tested in uni- and multivariate models.
There were 25 (14%) benign lesions, 38 (21%) neoplasms of uncertain behaviour, 100 well-differentiated carcinomas (56%) and 17 poorly differentiated carcinomas (9%). Radical resection was possible in 93 cases (51.6%). Overall 5-, 10- and 15-year survival rates were 67%, 49.3% and 32.8%, respectively, and were significantly higher in radically resected patients (93%, 80.8% and 65.2%, respectively; P < 0.00001). By multivariate analysis, poor differentiation [hazard ratio (HR) 7.3; P = 0.0001], nodal metastases (HR 3.05; P = 0.02), liver metastases (HR 3.29; P = 0.003), K(i)-67 >5% (HR 2.5; P = 0.012) and weight loss (HR 3.06; P = 0.001) were significantly associated with mortality.
This study confirms the good long-term survival of patients with NF-PETs and the prognostic value of WHO classification, liver metastases, poor differentiation, Ki-67, nodal metastases and weight loss. These latter two parameters have a prognostic value similar to that of liver metastases and Ki-67.
无功能性胰腺内分泌肿瘤（NF-PETs）是一种侵袭性胃肠胰腺肿瘤。本研究评估了NF-PETs患者的生存率、世界卫生组织（WHO）分类的价值以及诊断时临床病理参数的预后效用。
1990年至2004年，180例NF-PETs患者被纳入前瞻性数据库，并在单变量和多变量模型中测试预后预测因素。
有25例（14%）良性病变，38例（21%）行为不确定的肿瘤，100例高分化癌（56%）和17例低分化癌（9%）。93例（51.6%）患者可行根治性切除。总体5年、10年和15年生存率分别为67%、49.3%和32.8%，根治性切除患者的生存率显著更高（分别为93%、80.8%和65.2%；P<0.00001）。多变量分析显示，低分化（风险比[HR]7.3；P=0.0001）、淋巴结转移（HR 3.05；P=0.02）、肝转移（HR 3.29；P=0.003）、Ki-67>5%（HR 2.5；P=0.012）和体重减轻（HR 3.06；P=0.001）与死亡率显著相关。
本研究证实了NF-PETs患者良好的长期生存率以及WHO分类、肝转移、低分化、Ki-67、淋巴结转移和体重减轻这些因素的预后价值。后两个参数的预后价值与肝转移和Ki-67相似。
