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胰腺神经内分泌肿瘤的预后因素和特征:单中心经验。

Prognostic factors and characteristics of pancreatic neuroendocrine tumors: single center experience.

机构信息

Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea.

出版信息

Yonsei Med J. 2012 Sep;53(5):944-51. doi: 10.3349/ymj.2012.53.5.944.

Abstract

PURPOSE

Pancreatic neuroendocrine tumors (PNET) are a rare subgroup of tumors. For PNETs, the predictive factors for survival and prognosis are not well known. The purpose of our study was to evaluate the predictive factors for survival and disease progression in PNETs.

MATERIALS AND METHODS

We retrospectively analyzed 37 patients who were diagnosed with PNET at Severance Hospital between November 2005 and March 2010. Prognostic factors for survival and disease progression were evaluated using the Kaplan-Meier method.

RESULTS

The mean age of the patients was 50.0±15.0 years. Eight cases (21.6%) were described as functioning tumors and 29 cases (78.4%) as non-functioning tumors. In univariate analysis of clinical factors, patients with liver metastasis (p=0.002), without resection of primary tumors (p=0.002), or American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) stage III/IV (p=0.002) were more likely to demonstrate shorter overall survival (OS). Patients with bile duct or pancreatic duct invasion (p=0.031), sized-lesions larger than 20 mm (p=0.036), liver metastasis (p=0.020), distant metastasis (p=0.005), lymph node metastasis (p=0.009) or without resection of primary tumors (p=0.020) were more likely to demonstrate shorter progression-free survival (PFS). In multivariate analysis of clinical factors, bile duct or pancreatic duct invasion [p=0.010, hazard ratio (HR)=95.046] and tumor location (non-head of pancreas) (p=0.036, HR=7.381) were confirmed as independent factors for predicting shorter PFS.

CONCLUSION

Patients with liver metastasis or without resection of primary tumors were more likely to demonstrate shorter OS. Patients with bile duct or pancreatic duct invasion or tumors located at body or tail of pancreas were more likely to demonstrate shorter PFS.

摘要

目的

胰腺神经内分泌肿瘤(PNET)是一种罕见的肿瘤亚群。对于 PNET,生存和预后的预测因素尚不清楚。我们研究的目的是评估 PNET 患者生存和疾病进展的预测因素。

材料和方法

我们回顾性分析了 2005 年 11 月至 2010 年 3 月在 Severance 医院诊断为 PNET 的 37 例患者。使用 Kaplan-Meier 方法评估生存和疾病进展的预后因素。

结果

患者的平均年龄为 50.0±15.0 岁。8 例(21.6%)为功能性肿瘤,29 例(78.4%)为非功能性肿瘤。在临床因素的单因素分析中,肝转移患者(p=0.002)、未切除原发肿瘤患者(p=0.002)或美国癌症联合委员会/国际癌症控制联盟(AJCC/UICC)分期 III/IV 期患者(p=0.002)更有可能表现出较短的总生存期(OS)。胆管或胰管侵犯的患者(p=0.031)、肿瘤大小大于 20mm 的患者(p=0.036)、肝转移的患者(p=0.020)、远处转移的患者(p=0.005)、淋巴结转移的患者(p=0.009)或未切除原发肿瘤的患者(p=0.020)更有可能表现出较短的无进展生存期(PFS)。在临床因素的多因素分析中,胆管或胰管侵犯(p=0.010,风险比[HR]=95.046)和肿瘤位置(非胰头部)(p=0.036,HR=7.381)被确认为预测较短 PFS 的独立因素。

结论

有肝转移或未切除原发肿瘤的患者更有可能表现出较短的 OS。有胆管或胰管侵犯或肿瘤位于体部或尾部的患者更有可能表现出较短的 PFS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6cd/3423842/5d957c55c329/ymj-53-944-g001.jpg

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