作　　者： (赵婷）; (陈炯煌）; (曹利平）;

机构地区： 浙江大学医学院附属邵逸夫医院普外科,杭州市310000

出　　处： 《中国肿瘤临床》 2017年第16期810-815,共6页

摘　　要： 目的:探讨胰腺神经内分泌肿瘤(pancreatic neuroendocrine tumors,PNETs)的发病特点、诊断、治疗及预后的影响因素。方法:回顾性分析2004年8月至2016年8月浙江大学医学院附属邵逸夫医院确诊为PNETs并接受手术治疗的患者63例。收集患者的临床资料,包括年龄、性别、肿瘤功能性、根治性切除等信息,通过单因素、多因素分析的方法求证各因素与预后之间的关系。结果:本研究患者总生存时间(overall survival,OS)为5~127个月,中位生存时间(median overall survival,mOS)为46.6个月。3年及5年生存率分别为88.8%和84.1%。在63例患者中,无功能型占65.1%(41/63),功能型占34.9%(22/63)。单因素分析结果显示淋巴结转移、肝转移、血管侵犯、TNM分期、病理分级以及是否行根治性手术与预后相关(P<0.05)。多因素分析结果并未显示其中存在影响PNETs预后的独立因素。结论:PNETs是一类低度恶性的异质性罕见肿瘤,TNM分期和世界卫生组织(WHO)病理分级能积极指导预后,且淋巴结转移、肝转移、血管侵犯情况对预后有影响。患者经积极手术,尤其是根治性手术可获得较好的预后。 Objective：To investigate the clinical characteristics,diagnosis,treatment,and prognostic factors of pancreatic neuroendocrine neoplasms（PNENs）.Methods：From August 2004 to August 2016,the clinical data of 63 patients with PNENs in the Sir Run Run Shaw Hospital,an affiliate of the Zhejiang University School of Medicine,were retrospectively analyzed.The data included age,gender,function,tumor location,tumor size,pathological characteristics,lymph nodes,metastasis,and treatment.Association of these factors with PNEN prognosis was proven by univariate analysis and multivariate analysis.Results：In our study,the patients＇ overall survival time was between 5 and 127 months;the median time was about 46.6 months.Moreover,the survival rates in three years and five years are 88.8% and 84.1% respectively.Univariate analysis showed that factors such as lymph node metastasis,liver metastasis,vascular invasion,TNM staging and pathological grading,and radical operation were associated with prognosis（P〈0.05）.We did not prove any of the factors to be an independent factor associated with poor short-term outcome by multivariate analysis.Conclusion：PNENs are rare low-grade malignant tumors with heterogeneity,which is why they can be erroneously diagnosed.AJCC TNM staging in 2017 and the WHO pathological classification in 2010 can actively guide the prognosis evaluation.The lymph node metastasis,liver metastasis,and vascular invasion affected the prognosis of PNENs.Patients with radical operation had improved prognosis.

关 键 词： 胰腺神经内分泌肿瘤 临床表现 诊断 治疗 预后