Luo Q, Liu Y N, Ma H Y, Li S, Huang J Y, Li G, Jin G
Department of Pancreatic Surgery, Changhai Hospital of Second Military Medical University, Shanghai 200433, China.
Zhonghua Wai Ke Za Zhi. 2017 Oct 1;55(10):755-759. doi: 10.3760/cma.j.issn.0529-5815.2017.10.008.
To discuss the clinical pathology characteristics, strategies of diagnosis and therapy, and related prognosis factors of pancreatic neuroendocrine tumors(pNET). Clinical data of 103 pNET cases in Department of Pancreatic Surgery, Changhai Hospital of Second Military Medical University were collected from January 2006 to December 2015. There were 44 males and 59 females, aged from 21 to 77 years with mean age of 48 years.Of the 103 patients, there were functional type in 21 cases and no functional type in 82 cases. Related factors on diagnosis and treatment were summarized. Moreover, univariate survival analysis was performed by Kaplan-Meier method, and COX proportional hazards model was used for multivariate survival analysis. The detection rates of the B-ultrasound, CT, MRI were 60.2%, 84.6% and 91.3%, respectively, and there were 44 cases located in pancreatic head, 18 cases in pancreatic neck and 41 cases in pancreatic body and tail.G1 was the most common pathological grade, and the positive rates of Chromogranin A, Syn, neuron-specific enolase and CAM5.2 were 97.1%, 97.1%, 91.3% and 93.2%, respectively. The results of statistical analysis showed that tumor grade(χ(2)=26.077, <0.05), Ki-67 index(χ(2)=25.427, <0.05), ENETS stage(χ(2)=5.915, <0.05), AJCC stage(χ(2)=8.411, <0.05), lymph node metastasis(χ(2)=4.770, <0.05) and distant metastasis(χ(2)=8.411, <0.05) were associated with the prognosis of pNET, and the tumor grade was an independent risk factor of the pNET' overall prognositic factors (=3.085, <0.01). The pNET can be located in any part of pancreas, and the combination of laboratory and various imaging examinations can help make early diagnosis. In addition, tumor grade, Ki-67 index, ENETS stage, AJCC stage, lymph node metastasis and distant metastasis were closely related to the prognosis of pNET, and the higher the tumor grade, the worse the prognosis.
探讨胰腺神经内分泌肿瘤(pNET)的临床病理特征、诊断与治疗策略及相关预后因素。收集2006年1月至2015年12月第二军医大学长海医院胰腺外科103例pNET患者的临床资料。其中男性44例,女性59例,年龄21~77岁,平均年龄48岁。103例患者中,功能性21例,无功能性82例。总结诊断和治疗的相关因素。此外,采用Kaplan-Meier法进行单因素生存分析,用COX比例风险模型进行多因素生存分析。B超、CT、MRI的检出率分别为60.2%、84.6%、91.3%,肿瘤位于胰头44例,胰颈18例,胰体尾41例。G1是最常见的病理分级,嗜铬粒蛋白A、突触素、神经元特异性烯醇化酶和CAM5.2的阳性率分别为97.1%、97.1%、91.3%、93.2%。统计分析结果显示,肿瘤分级(χ(2)=26.077,P<0.05)、Ki-67指数(χ(2)=25.427,P<0.05)、ENETS分期(χ(2)=5.915,P<0.05)、AJCC分期(χ(2)=8.411,P<0.05)、淋巴结转移(χ(2)=4.770,P<0.05)及远处转移(χ(2)=8.411,P<0.05)与pNET的预后相关,肿瘤分级是pNET总体预后因素的独立危险因素(β=3.085,P<0.01)。pNET可发生于胰腺的任何部位,实验室检查与多种影像学检查相结合有助于早期诊断。此外,肿瘤分级、Ki-67指数、ENETS分期、AJCC分期、淋巴结转移及远处转移与pNET的预后密切相关,肿瘤分级越高,预后越差。