胰腺神经内分泌肿瘤37例临床特征分析和远期生活质量分析

Clinical characteristics analysis and long-term quality of life analysis of 37 cases of pancreatic neuroendocrine neoplasms

目的分析胰腺神经内分泌肿瘤(pNENs)的临床特征与外科治疗方法。方法收集并分析苏州大学附属第一医院于2013年1月~2018年7月间收治的37例pNENs患者的临床资料,包括患者一般情况、临床特征、手术方式、病理结果以及生存时间、术后生活质量等。结果37例患者中,男21例,女16例;年龄19~73岁,平均46岁。其中无功能性肿瘤28例(75.68%),功能性肿瘤9例(24.32%),均行根治手术治疗。采用门诊和电话方式进行随访,随访时间截止至2019年1月1日。根据WHO2017版分级标准G1、G2、G3级肿瘤患者5年生存率分别为100%、91.7%、33.3%。根据AJCC第8版TNM肿瘤分期,I、Ⅱ、Ⅲ、Ⅳ期患者5年生存率分别为100%、88.9%、33.3%、0。临床单因素分析结果表明,肿瘤分级、肿瘤TNM分期、有无区域淋巴结转移与患者预后有关(P<0.05)。对有功能与无功能pNENs患者作远期生活质量评估对比,差异无统计学意义(P>0.05)。结论pNENs的临床表现复杂多变,结合影像学检查以及相关实验室检查有助于疾病的诊断,目前手术切除仍是主要治疗手段,制定合适的手术治疗方案可较好改善患者远期生活质量及预后。

Objective To analyze the clinical features and surgical treatment of pancreatic neuroendocrine neoplasms(PNENs).Methods The clinical data of 37 patients with pNENs,which were treated in the First Affiliated Hospital of Soochow University from January 2013 to July 2018 were collected and analyzed,the data including general conditions,clinical features,surgical methods,pathological results,survival time and postoperative quality of life.Results Among the 37 patients,21 cases were male and 16 cases were female;the age ranged from 19 to 73 years old,with a mean age of 46.Among them,28cases(75.68%)of non-functional tumors and 9 cases(24.32%)of functional tumors.All them were treated with radical surgery.All the patients followed up by outpatient and telephone.The follow-up time was until January 1,2019.According to the tumor grading criteria(WHO,2017 version),survival rates after surgery in 5 years with G1,G2 and G3 were 100%、91.7%、33.3%,respectively.According to the tumor staging criteria(AJCC,the eighth version),survival rates after surgery in 5 years with I,II,III and IV were respectively 100%、88.9%、33.3%、0.00%.The clinical univariate analysis revealed that pathological grading,TNM staging,and regional lymph node metastasis were associated with prognosis(P<0.05).The long-term quality of life was no statistically difference between functional pNENs and non-functional pNENs(P>0.05).Conclusion The clinical manifestations of pNENs are complex and variable.Combined with imaging examination and related laboratory tests,it is helpful for the diagnosis of diseases.At present,surgical resection is the most important therapy,and an appropriate surgical treatment can improve long-term quality of life and prognosis.