Abstract
objective To analyze the diagnosis, surgical treatment and prognostic factors of pancreatic neuroendocrine tumors (pNETs). Methods The clinical data of 30 patients admitted in our hospital during Mar. 2006 to Jul. 2015 were retrospectively analyzed. Survival analysis was carried out by Kaplan-Meier method. Results Among the 30 patients, 11 were males and 19 were females, with the average age of 47 years old. 12 patients got functional pNETs and the rest got non-functional pNETs. Patients with functional pNETs were mainly manifested with the increase of the blood hormone level and corresponding hormone syndrome, such as Whipple triad and Zollinger-Ellison syndrome; patients with non-functional pNETs displayed nonspecific space-occupying symptoms in pancreas, such as abdominal pain, abdominal distension, and jaundice. The detection rates of type-B ultrasonic, CT, MRI and EUS on pancreatic tumors were 66.67% (10/15), 95.65% (22/23), 100% (9/9), and 100% (2/2), respectively. All the 30 patients received surgical treatments, 28 took radical surgeries, and 2 underwent palliative surgeries. There were hepatic metastases in 4 cases, lymph node metastases in 5 cases, vascular invasion in 2 cases, and nerve invasion in 1 case. 28 patients got followed-up successfully after surgery, with the average follow-up duration of 59.57 mon, showing 83.4% in five-year survival rates. Accord-ing to TNM tumor staging criteria [American Joint Committee on Cancer (AJCC), version 7], there were 17, 6, 2 and 3 patients with stage I, II, III and IV, respectively, and their corresponding five-year survival rates were 100%, 83.3%, 50.0% and 33.3%, respectively. According to the tumor grading criteria [World Health Organiza-tion (WHO), 2010 version], patients with G1, G2 and G3 were 8, 5 and 2, respectively in the patients admitted after 2010, and the corresponding five-year survival rates were 100%, 75.0% and 50.0%, respectively. Single fac-tor analysis suggested that tumor grading (WHO, 2010 version), TNM tumor staging (AJCC version 7), hepatic metastases, lymph node metastases were associated with the prognosis of pNETs patients (P<0.05). Conclusion The primary diagnosis of pNETs depends on special clinical syndromes, specific biochemical indexes, and the higher sensitivity of imaging examinations, while the final diagnosis still needs evidence of pathology. Surgery is the only potentially curative approach for pNETs. Tumor grading (WHO, 2010 version) and TNM tumor staging (AJCC version 7) are preferably available to assess the prognosis and survival state of patients with pNETs.关键词
神经内分泌肿瘤/胰腺/诊断/治疗/预后Key words
neuroendocrine tumours/pancreas/diagnosis/treatment/prognosis分类
医药卫生
