胰腺内分泌肿瘤：一项大型单中心经验。

Pancreatic endocrine tumors: a large single-center experience.

机构信息

Unité d'Exploration Médico-Chirurgicale Oncologique, Institut Paoli-Calmettes, Marseille, France.

出版信息

Pancreas. 2009 Nov;38(8):936-40. doi: 10.1097/MPA.0b013e3181b365db.

DOI:10.1097/MPA.0b013e3181b365db

PMID:19672207

Abstract

OBJECTIVES

Pancreatic endocrine tumors (PETs) are infrequent, which makes large experiences unlikely. Our aim was to describe a large single-center experience with PETs and the use of endoscopic ultrasound (EUS) and a cancer staging system (TNM).

METHODS

This study involves a retrospective analysis of 86 patients (44 men; age, 58 +/- 14 years) who underwent EUS-fine needle aspiration (EUS-FNA). Immunohistochemistry was used. Lesions were classified as recommended by TNM classification.

RESULTS

Typical EUS features were well-demarcated, hypoechoic, solid, homogeneous lesions. Ninety percent had the diagnosis obtained by EUS-FNA. Twelve PETs (14%) were functioning, 8 (9.3%) were cystic, and 14 (16%) were 10 mm or smaller. Nonfunctional PETs and larger lesions were more advanced. The TNM stage was I in 24, II in 10, III in 18, and IV in 34 patients. Sixteen patients (27%) died, and 30 patients (52%) had progression/recurrence during the follow-up (34 +/- 27 months). TNM stage and surgery with curative intent were related to progression. The overall 5-year survival was 60%. The mean survival time was 94 +/- 12 months for stage I, 52 +/- 12 months for stage III, and 54 +/- 7 months for stage IV (P = 0.06).

CONCLUSIONS

Nonfunctional PETs were more common and advanced. The EUS-FNA has a high accuracy for diagnosing PETs. Progression and poorer survival were associated with TNM stage.

摘要

目的

胰腺内分泌肿瘤（PETs）较为罕见，因此难以获得大量经验。我们的目的是描述一个大型单中心的 PET 经验，以及使用内镜超声（EUS）和癌症分期系统（TNM）。

方法

本研究回顾性分析了 86 名（44 名男性；年龄 58 +/- 14 岁）接受 EUS-细针抽吸（EUS-FNA）的患者。使用免疫组织化学。病变按 TNM 分类推荐进行分类。

结果

典型的 EUS 特征是边界清楚、低回声、实性、均匀的病变。90%的患者通过 EUS-FNA 获得诊断。12 例 PET（14%）为功能性，8 例（9.3%）为囊性，14 例（16%）为 10 毫米或更小。无功能性 PET 和较大的病变更为晚期。TNM 分期为 I 期 24 例，II 期 10 例，III 期 18 例，IV 期 34 例。16 例患者（27%）死亡，30 例患者（52%）在随访期间（34 +/- 27 个月）出现进展/复发。TNM 分期和以治愈为目的的手术与进展有关。总 5 年生存率为 60%。I 期的平均生存时间为 94 +/- 12 个月，III 期为 52 +/- 12 个月，IV 期为 54 +/- 7 个月（P = 0.06）。