Department of Surgery, S. Cuore-Don Calabria Hospital, Negrar, Verona, Italy.
Surgery. 2011 Jul;150(1):75-82. doi: 10.1016/j.surg.2011.02.022.
Tumor size is a criterion of staging in nonfunctioning pancreatic endocrine tumors as well as a predictor of outcome after curative resection. This study analyzes the correlation between tumor size and malignancy in patients with nonfunctioning pancreatic endocrine tumors.
All patients with nonfunctioning pancreatic endocrine tumors who underwent curative resection (R0) at our institution between 1990 and 2008 were considered. Their clinicopathologic characteristics were compared among 3 different groups according to tumor size. Univariate and multivariable analyses were performed.
Over the study period, 177 patients were identified. Overall, 90 patients (51%) had a tumor size ≤2 cm (group 1), 46 (26%) had tumor size between >2 cm and ≤4 cm (group 2), and 41 (23%) had tumor size >4 cm (group 3). Tumors ≤2 cm were more frequently incidentally discovered (group 1, 57% vs group 2, 51% vs group 3, 32%; P = .014) and benign (group 1, 81% vs group 2, 65% vs group 3, 5%; P < .0001). The presence of a nonfunctioning pancreatic endocrine tumor >2 cm and a nonincidental diagnosis of the tumor were independent predictors of malignancy at multivariable analysis. None of the 51 patients (29%) with a pancreatic endocrine tumor ≤2 cm that was incidentally diagnosed died of disease.
A strict correlation between tumor size and malignancy in nonfunctioning pancreatic endocrine tumors was demonstrated. A nonoperative management could be advocated for tumors ≤2 cm when discovered incidentally.
肿瘤大小是非功能性胰腺内分泌肿瘤的分期标准，也是治愈性切除术后预后的预测因素。本研究分析了非功能性胰腺内分泌肿瘤患者的肿瘤大小与恶性程度之间的相关性。
本研究纳入了 1990 年至 2008 年期间在我院接受治愈性切除（R0）的所有非功能性胰腺内分泌肿瘤患者。根据肿瘤大小将其分为 3 组，比较各组患者的临床病理特征。进行单因素和多因素分析。
研究期间共发现 177 例患者。总体而言，90 例（51%）患者肿瘤大小≤2cm（组 1），46 例（26%）肿瘤大小在>2cm 至≤4cm 之间（组 2），41 例（23%）肿瘤大小>4cm（组 3）。肿瘤≤2cm 更常为偶然发现（组 1，57%比组 2，51%比组 3，32%；P=0.014），且多为良性（组 1，81%比组 2，65%比组 3，5%；P<0.0001）。肿瘤>2cm 且为非偶然诊断是非功能性胰腺内分泌肿瘤恶性的独立预测因素。在多因素分析中，51 例偶然发现且肿瘤大小≤2cm 的患者中无 1 例死于该病。
本研究证实了非功能性胰腺内分泌肿瘤中肿瘤大小与恶性程度之间存在严格的相关性。对于偶然发现的≤2cm 的肿瘤，可以提倡非手术治疗。
