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胆囊神经内分泌癌的年龄特异性临床病理特征及预后分析。

Age-specific clinicopathological characteristics and prognostic analysis of neuroendocrine carcinomas of the gallbladder.

机构信息

Department of Biliopancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Cancer Med. 2022 Feb;11(3):641-653. doi: 10.1002/cam4.4463. Epub 2021 Nov 28.

Abstract

BACKGROUND

We have limited information about neuroendocrine carcinoma (NEC) of the gallbladder. The purpose of this paper is to compare clinical and pathological features between different age groups and prognostic factors for gallbladder NEC and how it differs from adenocarcinoma (ADC) of the gallbladder.

PATIENTS AND METHODS

This study included 28 gallbladder NEC patients and 137 ADC patients whose clinical characteristics and pathological findings were retrospectively collected. Propensity score matching and Cox regression analysis were used for the analysis of prognostic factors.

RESULTS

We divided NEC patients into two groups based on the age more than or less than 60 years. Most of the NEC patients less than 60 years old complained of abdominal pain or discomfort (p = 0.038), and more younger patients accepted adjuvant therapy (p = 0.020) than older patients did. CD56 was positive in all patients more than 60 years old, which is significantly higher than that of younger patients (p = 0.039). The mean age was similar between NEC and ADC patients. After eliminating confounding factors between NEC and ADC patients, the overall survival rates were still lower in NEC patients. Univariate analysis extracted six possible risk factors. Multivariate analysis indicated that surgery type, tumor size, and existence of gallstones were independent prognostic factors.

CONCLUSION

The overall survival of gallbladder NEC is not associated with age. In this study, surgical method and tumor size were found to be independent risk factors for NECs. In addition, NEC patients have a worse prognosis than ADC patients with similar clinical and pathological features.

摘要

背景

我们对胆囊神经内分泌癌(NEC)的了解有限。本文旨在比较不同年龄组胆囊 NEC 的临床和病理特征,以及胆囊 NEC 与胆囊腺癌(ADC)的预后因素有何不同。

患者与方法

本研究纳入了 28 例胆囊 NEC 患者和 137 例胆囊 ADC 患者,回顾性收集了他们的临床特征和病理发现。采用倾向评分匹配和 Cox 回归分析进行预后因素分析。

结果

我们根据年龄是否大于或小于 60 岁将 NEC 患者分为两组。大多数年龄小于 60 岁的 NEC 患者主诉腹痛或不适(p=0.038),且较年长患者接受辅助治疗的比例更高(p=0.020)。所有年龄大于 60 岁的患者 CD56 均为阳性,明显高于年龄小于 60 岁的患者(p=0.039)。NEC 和 ADC 患者的平均年龄相似。在消除 NEC 和 ADC 患者之间的混杂因素后,NEC 患者的总体生存率仍然较低。单因素分析提取了 6 个可能的危险因素。多因素分析表明手术方式、肿瘤大小和胆囊结石的存在是独立的预后因素。

结论

胆囊 NEC 的总体生存率与年龄无关。在本研究中,手术方式和肿瘤大小被发现是 NEC 的独立危险因素。此外,具有相似临床和病理特征的 NEC 患者预后比 ADC 患者差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c52/8817078/47cc712c98f1/CAM4-11-641-g001.jpg

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