70例无功能胰岛细胞瘤的临床病理特征及预后分析

Analysis of clinicopathologic characteristics and prognostic factors in non-functioning islet cell tumor:A report of 70 cases

目的:探讨无功能胰岛细胞瘤(NFICT)的临床病理特征及预后的相关因素。方法:回顾性分析天津医科大学附属肿瘤医院10年间收治的70例无功能胰岛细胞瘤患者的临床资料,分别对年龄、性别、腰背部疼痛、肿瘤直径、手术方式及淋巴结转移等因素进行预后分析。结果:本组70例患者良性31例(44.3%),恶性39例(55.7%)。全组患者中位生存期为88个月,术后1、3、5年总生存率分别为82.4%、68.8%、52.8%。单因素分析显示,患者的预后与肿瘤直径、原发肿瘤性质、手术方式、TNM分期、淋巴结转移情况有关(P<0.05)。多因素分析显示,肿瘤直径(P=0.001)、手术方式(P<0.001)、淋巴结转移情况(P=0.002)是患者预后的独立影响因素。结论:肿瘤直径<10 cm、无淋巴结转移和肿瘤完全性切除常提示无功能胰岛细胞瘤患者预后较好。

Objective： This work aimed to investigate the clinicopathologic characteristics of non-functioning islet cell tumor （NFICT） and to analyze the homologous prognostic factors. Methods：Clinical data of 70 surgically treated patients with pathologically confirmed NFICT over the past 10 years were analyzed. The patients were admitted in Tianjin Medical University Tianjin Cancer Hospi-tal. The related factors, such as patient age and gender, pre-operative abdominal and/or back pain, CA19-9 level, tumor size, pathologic type, surgical procedure, tumor-node-metastasis （TNM） stage lymphatic metastasis and adjuvant therapy, were analyzed. Results： Of the 70 patients, 39 were diagnosed with non-functioning islet cell carcinomas and 31 with benign islet cell tumors. In the 70 cases, the median survival time was 88 months, and the 1-, 3-, and 5-year overall survival times were 82.4%, 68.8%, and 52.8%, respectively. Uni-variate analysis showed that tumor size, pathologic type, surgical procedure, TNM stage, and lymphatic metastasis were associated with the prognosis （P〈0.05）. Multivariate analysis showed that tumor size （P=0.001）, surgical procedure （P=0.000）, and lymphatic metasta-sis （P=0.002） were predictors of prognosis. Conclusion：Small tumor size （P〈10 cm）, absence of lymphatic metastasis, and radical re-section improve the survival of NFICT patients.