胰腺神经内分泌肿瘤9例临床分析

Pancreatic neuroendocrine neoplasms: a clinical analysis of 9 cases

目的:探讨胰腺神经内分泌肿瘤(PNEN)临床及病理特点、诊断与治疗方法,为进一步提高该病的认识提供帮助。方法:回顾性分析2011年12月—2013年12月期间安徽医科大学第一附属医院收治的9例PNEN患者的临床及病理资料。结果:9例患者中,男3例,女6例;9例均行B超及CT检查,2例行MRI检查。影像学提示肿瘤位于胰头部3例,颈体部1例,胰尾部1例,体尾部3例,体尾部及肝脏膈面发现结节1例。9例患者有不同的临床症状,胰岛细胞瘤1例,可见明显的低血糖症状,具体表现为头晕、乏力,并伴随有嗜睡、饥饿感、神志不清,其余患者无典型症状;所有患者均接受手术治疗,均经术后病理及免疫组化证实。结论:PNEN发病率低,起病隐匿,常无典型临床症状和体征,确诊主要依靠病理活检及免疫组化,目前手术治疗为其首选的治疗方法。

Objective： To investigate the cliniopathologic features, diagnosis and treatment of pancreatic neuroendocrine neoplasms （PNEN）, so as to provide knowledge for further understanding of this condition. Methods： The clinical and pathological data of the 9 PNEN patients admitted in the First Affiliated Hospital of Anhui Medical University from December 2011 to December 2013 were retrospectively analyzed. Results： Of the 9 patients, 3 cases were male and 6 were female; all cases underwent ultrasound and CT examination, and 2 cases had MRI examination. The imaging examinations showed that the tumor was located in the head of the pancreas in 3 cases, neck of the pancreas in one case, the tail of the pancreas in one case, the body and tail of the pancreas in 3 cases, and body and tail of the pancreas with concomitant tumor in the diaphragmatic surface of the liver in one case. The 9 patients exhibited dissimilar clinical symptoms, of whom one case with islet cell tumor had typical symptoms of hypoglycemia such as dizziness and fatigue accompanied with drowsiness, hunger sensation and unconsciousness, and the other cases had no typical symptoms. All patients received surgical treatment, and their diagnoses were confirmed by postoperative pathological and immunohistochemical examinations. Conclusion： PNEN has low prevalence, insidious onset and usually without specific clinical signs and symptoms. Its diagnosis mainly relies on pathological biopsy and immunohistochemical staining, and surgery is the first option of treatment.