无功能性胰腺神经内分泌肿瘤的外科治疗及预后分析

Surgical treatment of non-functional pancreatic neuroendocrine tumor and its prognosis

目的探讨无功能性胰腺神经内分泌肿瘤的临床特点及外科治疗。方法回顾性分析本院2003年1月-2012年11月诊治的79例无功能性胰腺神经内分泌肿瘤患者的临床资料。分析不同分组患者资料之间的差异以及可能对患者预后有影响的相关因素。结果患者临床表现不典型。肿瘤位于头部50例,体尾部29例。按照TNM分期,Ⅰ期41例,Ⅱ期20例,Ⅲ期10例,Ⅳ期8例。行胰体尾切除术(含脾切除)22例,胰十二指肠切除术19例,肿瘤局部切除24例,姑息性手术14例。多因素分析预后与TNM分期有关。结论根治性切除可明显提高无功能性神经内分泌肿瘤患者的预后;TNM分期是患者预后的独立影响因素。

Objective To study the clinical features of non-functional pancreatic neuroendocrine tumor and its surgical treatment. Methods Clinical data about 79 patients with nonfunctional pancreatic neuroendocrine tumor admitted to our hospital from January 2003 to November 2012 and the influencing factors for its prognosis were retrospectively analyzed. Results The patients had no typical clinical manifestations. The tumor was located in pancreatic head of 50 cases and in pancreatic body and tail of 29 cases. The tumor was classified as stages I ,II , III and IV in 41, 20, 10 and 8 patients, respectively, according to the TNM classification. Of the 79 patients, 22 underwent distal pancreatectomy （including splenectomy）, 19 pancreaticoduodenectomy, 24 enucleation, and 14 palliative surgery. Multivariate analysis showed that the prognosis of the tumor was related with its TNM staging （P 〈 0.01）. Conclusion Radical resection of nonfunctional pancreatic neuroendocrine tumor can significantly improve its outcome. TNM staging is an independent factor for the prognosis of such patients.