胰腺神经内分泌肿瘤预后相关因素的临床研究

Clinical evaluation of prognostic factors in pancreatic neuroendocrine tumor

目的分析胰腺神经内分泌肿瘤的预后与治疗手段及临床病理类型的关系。方法回顾性分析经病理确诊的86例胰腺神经内分泌肿瘤患者的年龄、性别、肿瘤病理类型、病理分级、TNM分期及手术治疗方式与无瘤生存期和5年生存率的关系。结果单因素分析显示,患者的无瘤生存期及5年生存率在肿瘤的病理分级和TNM分期方面差异均有统计学意义(均P<0.05),根治性手术为主的综合治疗能够改善患者预后。多因素分析显示,病理分级G1级的死亡风险是G2、G3级的0.18倍,TNM分期Ⅰ、Ⅱ期的死亡风险是Ⅲ、Ⅳ期0.21倍。结论胰腺神经内分泌肿瘤的预后与病理分级及TNM分期有关,以手术为主的综合治疗能够有效改善其预后。

Objective To analyze the relationship of the prognosis of pancreatic neuroendocrine tumor with its treatment and clinical pathological parameters. Methods Eighty-six cases of pathologically confirmed pancreatic neuroendocrine tumors were enrolled. The relationship of age,gender,tumor pathological type,pathological grade,TNM stage and surgical treatment with patients＇ disease-free survival and 5-year survival rate was retrospectively analyzed. Results Univariate analysis showed that disease-free survival and 5-year survival rate were significantly different in patients with different pathological grade and TNM stage（ P〈 0. 05）. Moreover,radical surgery based comprehensive therapy can significantly improve the prognosis. Multivariate analysis suggested that the mortality risk of G1 tumor grade patient was 0. 18 fold of that of G2 and G3 grade patients. Similarly,the mortality risk of patients with TNM Ⅰ-Ⅱ stage tumor is 0. 21 fold of that of TNM Ⅲ-Ⅳ stage patients. Conclusion The prognosis of pancreatic neuroendocrine tumor is related to the pathological grade and TNM stage,and can be improved effectively by surgery based comprehensive therapy.