Choi Jin Ho, Choi Young Hoon, Kang Jinwoo, Paik Woo Hyun, Lee Sang Hyub, Ryu Ji Kon, Kim Yong-Tae
From the Department of Internal Medicine, Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Pancreas. 2018 Nov/Dec;47(10):1357-1363. doi: 10.1097/MPA.0000000000001187.
Nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs) are a rare disease but have been diagnosed more frequently than before. The aim of this study was to evaluate the natural course of small NF-PNETs.
We performed a retrospective analysis of patients with incidentally found small NF-PNETs (<20 mm) from 1999 to 2015. The patients who were recommended surveillance were included.
There were 69 patients with small NF-PNETs with a mean size of 10.9 (standard deviation [SD], 3.1) mm. The average follow-up period was 52.2 (SD, 38.7) months. The changes in tumor size were as follows: increased (13.0%), sustained (84.1%), and decreased (2.9%). Eighteen were evaluated with grade 1 NF-PNETs and 1 with grade 2 among the obtained tissues. Thirteen patients underwent surgery after an average 32.9 (SD, 42.6) months later. There were 7 patients of Ia, 1 of Ib, 2 of IIa, and 1 of IIb according to the pathologic stages. Two patients received reoperation for recurrent tumors, and 2 patients showed distant metastasis after surgery, but no disease-related death occurred.
Most of the small NF-PNETs did not increase in size and seldom showed metastasis. The wait-and-see strategy can be used for NF-PNETs less than 2 cm.
无功能性胰腺神经内分泌肿瘤（NF-PNETs）是一种罕见疾病，但目前其诊断率比以往更高。本研究旨在评估小型NF-PNETs的自然病程。
我们对1999年至2015年间偶然发现的小型NF-PNETs（<20 mm）患者进行了回顾性分析。纳入了建议进行监测的患者。
共有69例小型NF-PNETs患者，肿瘤平均大小为10.9（标准差[SD]，3.1）mm。平均随访期为52.2（SD，38.7）个月。肿瘤大小变化如下：增大（13.0%）、稳定（84.1%）、缩小（2.9%）。在所获取的组织中，18例为1级NF-PNETs，1例为2级。13例患者在平均32.9（SD，42.6）个月后接受了手术。根据病理分期，Ia期7例，Ib期1例，IIa期2例，IIb期1例。2例患者因复发肿瘤接受了再次手术，2例患者术后出现远处转移，但未发生与疾病相关的死亡。
大多数小型NF-PNETs大小未增加，很少发生转移。对于小于2 cm的NF-PNETs可采用观察等待策略。
