Lee Kyong Joo, Cho Jae Hee, Lee Sang Hyub, Lee Kwang Hyuk, Park Byung Kyu, Lee Jun Kyu, Woo Sang Myung, Ryu Ji Kon, Lee Jong Kyun, Kim Yeon Suk, Kim Jae Woo, Lee Woo Jin
a Department of Internal Medicine , Yonsei University Wonju College of Medicine , Wonju , South Korea.
b Department of Internal Medicine , Gachon university, Gil Medical Center , Incheon , South Korea.
Scand J Gastroenterol. 2017 Apr;52(4):437-441. doi: 10.1080/00365521.2016.1261938. Epub 2016 Dec 7.
This study assessed the clinicopathological features, therapeutic approaches, and prognosis of patients with biliary neuroendocrine neoplasm (NENs).
Multicenter retrospective study of patients with biliary tract NENs in the gallbladder, the extrahepatic bile duct, or the ampulla of Vater between 2005 and 2014.
Total of 43 patients were included in the study. The median age was 62 years (range: 29-84 years) and 58.1% of the patients were male. The tumors occurred in the gallbladder (n = 11), the extrahepatic bile duct (n = 5) or the ampulla of Vater (n = 27). The liver was the most common metastatic site. Based on the 2010 World Health Organization classification, more patients with gallbladder NENs (11/11 (100%)) had neuroendocrine carcinoma G3 than those with NENs in the ampulla of Vater (10/27 (37.1%)). The median progression free survival time (39.3 vs 5.1 months, p = 0.001) and median overall survival time (46.9 vs 7.9 months, p < 0.001) were significantly longer in patients with ampulla of Vater NENs than gallbladder NENs. A 2010 World Health Organization classification of neuroendocrine carcinoma G3 was independently related to poor overall survival (hazard ratio (HR), 27.1; 95% confidence intervals (CI), 2.81-260.68; p = 0.004).
The 2010 World Health Organization classification of neuroendocrine carcinoma G3 was the only factor related to poor prognosis in patients with biliary neuroendocrine neoplasms.
本研究评估了胆道神经内分泌肿瘤(NENs)患者的临床病理特征、治疗方法及预后。
对2005年至2014年间胆囊、肝外胆管或Vater壶腹的胆道NENs患者进行多中心回顾性研究。
本研究共纳入43例患者。中位年龄为62岁(范围:29 - 84岁),58.1%的患者为男性。肿瘤发生于胆囊(n = 11)、肝外胆管(n = 5)或Vater壶腹(n = 27)。肝脏是最常见的转移部位。根据2010年世界卫生组织分类,胆囊NENs患者中神经内分泌癌G3的比例(11/11(100%))高于Vater壶腹NENs患者(10/27(37.1%))。Vater壶腹NENs患者的中位无进展生存时间(39.3 vs 5.1个月,p = 0.001)和中位总生存时间(46.9 vs 7.9个月,p < 0.001)显著长于胆囊NENs患者。2010年世界卫生组织神经内分泌癌G3分类与总体生存不良独立相关(风险比(HR),27.1;95%置信区间(CI),2.81 - 260.68;p = 0.004)。
2010年世界卫生组织神经内分泌癌G3分类是胆道神经内分泌肿瘤患者预后不良的唯一相关因素。