原发性肝脏神经内分泌肿瘤的诊断与手术切除治疗

Diagnostics and surgical resection of primary hepatic neuroendocrine neoplasms

目的探讨肝脏原发性神经内分泌肿瘤（primary hepatic neuroendocrinene oplasm，PHNEN）诊断和手术切除疗效。方法回顾分析2006年8月至2014年6月本组手术治疗18例PHNEN临床资料，采用Kaplan-Meier方法进行术后生存分析。结果本组无手术死亡，术后全部获得随访，平均随访时间42．7个月，术后生存时间8～89个月，死亡4例，总生存时间分别为8、15、18、59个月。术后1、3、5年累计复发率分别为16．7％、50．0％、70．0％，1、3、5年实际累计生存率分别为94．4％、75．0％、50．0％。是否根治性切除与肿瘤细胞增殖活性分级是影响PHNEN手术预后的因素。结论PHNEN恶性程度较低，明确诊断需依据病理学检查，根治性手术切除、增殖活性分级G1和G2型肿瘤预后较好。

Objective To explore the diagnostics and surgical outcomes of primary hepatic neu- roendocrine neoplasms （PHNEN）. Methods The clinical data of 18 surgical patients with a pathological diagnosis of PHNEN were retrospectively reviewed and analyzed. Survival analysis was conducted with Kaplan-Meier method. Results No surgical death occurred. The average follow-up period was 42. 7 months. The range of overall survival （OS） was 8-89 months. Four patients died with the values of OS at 8, 15, 18 and 59 months respectively. The cumulative recurrence rates in 1, 3 and 5 years were 16. 7%, 50. 0% and 70. 0% respectively. And actual survival rates in 1, 3 and 5 years were 94. 4%, 75.0% and 50. 0% respectively. And R0 resection and proliferating grading of tumor cells were the influencing factors of postoperative OS. Conclusions PHNEN has fair postoperative out- comes. And the patients receiving radical resection （R0） or with a G1 or G2 proliferating grading may achieve a longer OS.