Singh Jassimran, Gudmundsdottir Hallbera, Halfdanarson Thorvardur R, Cleary Sean P, Kendrick Michael L, Truty Mark J, Smoot Rory L, Nagorney David M, Vege Santhi Swaroop
Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA.
Departments of Surgery.
Pancreas. 2025 May 1;54(5):e423-e429. doi: 10.1097/MPA.0000000000002452.
Pancreatic neuroendocrine tumors (pNETs) are uncommon, comprising 3%-7% of pancreatic tumors. With increasing incidence due to advanced imaging techniques, there is a need for detailed characterization of these tumors. This study aims to describe the clinical features, diagnostic evaluations, and pathology characteristics of pNETs in a large cohort from a single tertiary center, and to compare these findings with other larger cohort studies.
We conducted a retrospective analysis of 866 patients with pNETs who underwent surgical resection at Mayo Clinic, Rochester, from March 2000 to December 2019. Data on demographics, clinical presentation, laboratory tests, imaging, and pathology were extracted and analyzed. Descriptive statistics were used to summarize the data.
The cohort had a median age of 57 years. Nonfunctional tumors were much more prevalent (77.5%), with functional tumors primarily being insulinomas (75.9%). Common presenting symptoms included gastrointestinal (45.3%) and nongastrointestinal symptoms (30.7%). Chromogranin A levels were elevated in 57.5% of patients. Imaging revealed enhancing lesions in most cases, with computed tomography scans performed in 90.9% of patients. Endoscopic ultrasound (EUS) identified tumors in 98.1% of cases, with EUS-FNA showing a sensitivity of 82%. Ki-67 index, used in 58.1% of cases, indicated grade 2 tumors as the most common (55.9%). Metastasis was observed in 39.4% of patients at the time of diagnosis, predominantly in the liver.
This study provides a comprehensive description of pNET characteristics in a large surgical cohort. Findings highlight the predominance of nonfunctional tumors and the importance of imaging and EUS in diagnosis. The data can aid in inter-institutional comparisons and enhance understanding of pNETs, contributing to improved patient management and future research.
胰腺神经内分泌肿瘤（pNETs）并不常见，占胰腺肿瘤的3%-7%。由于先进成像技术的应用，其发病率不断上升，因此需要对这些肿瘤进行详细的特征描述。本研究旨在描述来自单一三级医疗中心的一大组患者中pNETs的临床特征、诊断评估和病理特征，并将这些结果与其他更大规模的队列研究进行比较。
我们对2000年3月至2019年12月在罗切斯特梅奥诊所接受手术切除的866例pNETs患者进行了回顾性分析。提取并分析了人口统计学、临床表现、实验室检查、影像学和病理学数据。采用描述性统计方法对数据进行总结。
该队列的中位年龄为57岁。无功能性肿瘤更为常见（77.5%），功能性肿瘤主要为胰岛素瘤（75.9%）。常见的临床表现包括胃肠道症状（45.3%）和非胃肠道症状（30.7%）。57.5%的患者嗜铬粒蛋白A水平升高。大多数病例的影像学检查显示有强化病变，90.9%的患者进行了计算机断层扫描。内镜超声（EUS）在98.1%的病例中发现了肿瘤，EUS引导下细针穿刺活检（EUS-FNA）的敏感性为82%。58.1%的病例使用了Ki-67指数，结果显示2级肿瘤最为常见（55.9%）。39.4%的患者在诊断时观察到转移，主要转移至肝脏。
本研究全面描述了一大组手术患者中pNETs的特征。研究结果突出了无功能性肿瘤的优势以及影像学和EUS在诊断中的重要性。这些数据有助于机构间的比较，并增进对pNETs的了解，有助于改善患者管理和未来研究。
