Lv Yang, Huang Cheng, Xu Haizhou, Han Xu, Zhang Lei, Mao Weilin, Ji Yuan, Jin Dayong, Lou Wenhui, Xu Xuefeng
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Hepatic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
J Cancer. 2018 Jan 1;9(3):479-487. doi: 10.7150/jca.22157. eCollection 2018.
We aim to describe the clinicopathological characteristics of hepatic neuroendocrine tumors (HNETs) and evaluate the relevant prognosis-related factors. The clinical data of 81 consecutive patients with primary or metastatic HNETs from March 2000 to July 2014 were retrospectively analyzed. The mean (SD) age was 59.68 (11.64) years, 69.15% were men. The percentages of Grade G1, G2 and G3 tumors were 4.94%, 25.93% and 69.13%, respectively. Thirty-five cases were primary HNETs. Primary HNETs were more common in patients with larger tumors, lymph nodes invasions, tumor necrosis and portal vein tumor thrombus. The 1-, 3-, and 5-year overall survival rate were 88.89%, 32.10%, and 8.64%, separately. The relapse rate was 81.48% (66/81) and the mean (SD) relapse time was 18.79 (10.99) months. Reduced survival rate was associated with lymph node metastases (P=0.034), tumor necrosis (P=0.048), hard texture of tumor character (P=0.001), multifocality of tumor numbers (P=0.043), and the immunohistochemical expression of NSE (P=0.000) and Syn (P=0.037). Patients with metastatic HNETs were demonstrated with a more decreased period of Progression-free Survival (PFS) and Overall survival (OS) than their primary HNETs counterparts (P<0.05). Primary HNETs cohort patients were more common with aggressive clinical presentation. The hard texture of tumor character, multifocality of tumor numbers, and the immunohistochemical expression of NSE and Syn were independent predictive factors. Patients who were pathologically diagnosed as the primary HNETs seemed to achieve a long-term survival.
我们旨在描述肝神经内分泌肿瘤（HNETs）的临床病理特征，并评估相关的预后相关因素。回顾性分析了2000年3月至2014年7月连续81例原发性或转移性HNETs患者的临床资料。平均（标准差）年龄为59.68（11.64）岁，男性占69.15%。G1、G2和G3级肿瘤的比例分别为4.94%、25.93%和69.13%。35例为原发性HNETs。原发性HNETs在肿瘤较大、有淋巴结侵犯、肿瘤坏死和门静脉瘤栓的患者中更常见。1年、3年和5年总生存率分别为88.89%、32.10%和8.64%。复发率为81.48%（66/81），平均（标准差）复发时间为18.79（10.99）个月。生存率降低与淋巴结转移（P=0.034）、肿瘤坏死（P=0.048）、肿瘤质地硬（P=0.001）、肿瘤多灶性（P=0.043）以及NSE（P=0.000）和Syn（P=0.037）的免疫组化表达有关。转移性HNETs患者的无进展生存期（PFS）和总生存期（OS）较原发性HNETs患者明显缩短（P<0.05）。原发性HNETs队列患者的临床表现更具侵袭性。肿瘤质地硬、肿瘤多灶性以及NSE和Syn的免疫组化表达是独立的预测因素。病理诊断为原发性HNETs的患者似乎能获得长期生存。
