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术前急性胰腺炎和高酶血症与无功能性胰腺神经内分泌肿瘤患者的预后不良相关。

Preoperative acute pancreatitis and hyperenzymemia are associated with poor prognosis in patients with nonfunctional pancreatic neuroendocrine tumors.

作者信息

Song Haiyu, Tan Qingquan, Yuan Yuan, Liu Xubao, Chen Yonghua, Wang Xing

机构信息

Department of Hepatobiliary and Pancreatic Surgery, Chengdu Second People's Hospital, Chengdu, Sichuan Province, China.

Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.

出版信息

J Surg Oncol. 2023 Jun;127(7):1135-1142. doi: 10.1002/jso.27227. Epub 2023 Mar 13.

Abstract

BACKGROUND

We aimed to investigate the prevalence of acute pancreatitis (AP) and hyperenzymemia as well as their clinical impact on postoperative survival outcomes in patients with pancreatic neuroendocrine tumors (PNETs).

METHODS

A retrospective cohort study of 218 patients who underwent radical surgical resection for nonfunctional PNETs (NF-PNETs) was conducted. Multivariate survival analysis was performed by the Cox proportional hazard model, with results expressed as hazard ratio (HR) and 95% confidence interval (CI).

RESULTS

Of the 151 patients who met the inclusion criteria, the incidences of preoperative AP and hyperenzymemia were 7.9% (12/152) and 23.2% (35/151), respectively. The mean recurrence-free survival (RFS, 95% CI) for patients in control, AP, and hyperenzymemia groups was 136 (127-144), 88 (74-103), and 90 (61-122) months, with a 5-year RFS rate of 86.5%, 58.3%, and 68.9%, respectively. In the multivariable-adjusted Cox hazard model that included tumor grade and lymph node status, the adjusted HR of AP and hyperenzymemia for recurrence was 2.58 (95% CI: 1.47-7.86, p = 0.008) and 2.43 (95% CI: 1.08-7.06, p = 0.040).

CONCLUSION

Preoperative AP and hyperenzymemia are associated with poor RFS following radical surgical resection in NF-PNETs patients.

摘要

背景

我们旨在调查急性胰腺炎(AP)和酶血症的患病率及其对胰腺神经内分泌肿瘤(PNETs)患者术后生存结局的临床影响。

方法

对218例行非功能性PNETs(NF-PNETs)根治性手术切除的患者进行回顾性队列研究。采用Cox比例风险模型进行多因素生存分析,结果以风险比(HR)和95%置信区间(CI)表示。

结果

在151例符合纳入标准的患者中,术前AP和酶血症的发生率分别为7.9%(12/152)和23.2%(35/151)。对照组、AP组和酶血症组患者的平均无复发生存期(RFS,95%CI)分别为136(127-144)、88(74-103)和90(61-122)个月,5年RFS率分别为86.5%、58.3%和68.9%。在包含肿瘤分级和淋巴结状态的多变量调整Cox风险模型中,AP和酶血症复发的调整后HR分别为2.58(95%CI:1.47-7.86,p = 0.008)和2.43(95%CI:1.08-7.06,p = 0.040)。

结论

术前AP和酶血症与NF-PNETs患者根治性手术后的不良RFS相关。

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