胃肠胰神经内分泌肿瘤患者预后的多因素分析

Multivariate prognostic analysis of gastrointestinal neuroendocrine pancreatic tumor

目的：分析胃肠胰神经内分泌肿瘤患者预后的危险因素,并探讨对应的干预对策,以期为临床提供借鉴。方法：回顾自2002年6月至2013年12月入院治疗的胃肠胰神经内分泌肿瘤患者的资料,对患者的一般情况如性别、年龄、肿瘤大小、肿瘤部位、肿瘤侵犯程度、淋巴结转移、血管侵犯、手术切缘、远处转移、总生存期等数据进行分析,总结胃肠胰神经内分泌肿瘤患者预后的危险因素。结果：123患者平均发病年龄56.9岁,男性平均发病年龄59.5岁,女性平均发病年龄52岁。〈60岁患者68例,≥60岁55例,从发病到明确诊断时平均时间为9.8月,中位生存时间为46.1个月,1年生存率为69%,3年生存率为37.4%,5年生存率为29.6%。通过单因素分析,年龄、肿瘤大小、肿瘤侵犯程度、淋巴结转移、血管侵犯、手术切缘、远处转移与胃肠胰神经内分泌肿瘤患者预后显著相关,P〈0.05;性别、肿瘤部位与胃肠胰神经内分泌肿瘤患者预后无明显相关,P分别为0.784、0.988。通过多因素COX回归分析,年龄（HR=1.93,95%CI：1.06-3.50）及远处转移（HR=1.83,95%CI：1.24-2.72）为胃肠胰神经内分泌肿瘤患者预后的独立危险因素。结论：年龄、肿瘤大小、肿瘤侵犯程度、淋巴结转移、血管侵犯、手术切缘、远处转移等是胃肠胰神经内分泌肿瘤患者生存预后的危险因素,年龄大、远处转移患者生存预后最差。

Objective： To analyze pancreatic neuroendocrine tumors of gastrointestinal prognostic risk factors,and explore the corresponding intervention measures. Methods： To retrospectively analyze data of 123 gastrointestinal and pancreatic neuroendocrine patients. Patient＇s general circumstances such as sex,age,tumor size,tumor location,tumor invasion,lymph node metastasis,vascular invasion,surgical margins,distant metastases,overall survival and other data for analyzed. Results： The mean age was 56. 9 years of 123 patients,average age 59. 5 years in men,women average age 52 years. 68 patients less than 60 years,greater than or equal to 60 years old were in 55 cases. The time from onset to diagnosis The mean time was 9. 8 months,median survival time was 46. 1 months,1 year survival rate was69%,3- year survival rate was 37. 4% 5- year survival rate was 29. 6%. By univariate analysis,age,tumor size,tumor invasion,lymph node metastasis,vascular invasion,surgical margins,distant metastasis was significantly correlated with the prognosis of patients with gastrointestinal and pancreatic neuroendocrine tumors,P〈 0. 05; gender,tumor site and gastrointestinal the prognosis of patients with pancreatic endocrine tumors of the nervous had no significant correlation,P = 0. 784,0. 988〉0. 05. Multivariate COX regression analysis showed age（ HR = 1. 93,95% CI： 1. 06 -3. 50） and distant metastasis（ HR = 1. 83,95% CI： 1. 24 - 2. 72） were independent risk prognosis factor. Conclusion： Age,tumor size,tumor invasion,lymph node metastasis,vascular invasion,surgical margins,distant metastasis are risk factors for gastrointestinal survival prognosis in patients with pancreatic neuroendocrine tumors,distant metastasis in patients with the worst prognosis of survival.