低钠血症对消化系统神经内分泌肿瘤患者预后的预测价值

Prognostic value of hyponatremia in patients with neuroendocrine neoplasms of digestive system

目的探讨低钠血症对消化系统神经内分泌肿瘤(neuroendocrine neoplasms,NENs)患者预后的预测价值。方法回顾性分析西安高新医院收治的148例消化系统NENs患者的临床资料,根据血钠水平分为低钠血症组和非低钠血症组,比较两组患者的临床病理特征,并进行生存分析。结果148例消化系统NENs患者中,低钠血症组51例(34.5%),非低钠血症组97例(65.5%)。低钠血症组患者神经内分泌癌(NEC)、发生淋巴结转移、发生远处转移及ECOG 3~4分者比例显著高于非低钠血症组(P<0.05)。两组中位生存时间分别为18和29个月,差异有统计学意义(P<0.05)。多因素分析显示,淋巴结转移、远处转移及低钠血症是影响患者总生存的独立预后因素(P<0.05)。结论伴有低钠血症的消化系统NENs患者生存期短,预后差,低钠血症在一定程度上可作为患者预后不良的一个预测因素。

Objective To investigate the prognostic value of serum hyponatremia in neuroendocrine neoplasms(NENs)of the digestive system.Methods The clinical data of 148 patients with NENs in the digestive system in Xi'an Gaoxin Hospital between January 2010 and December 2017 were retrospectively analyzed.The patients were divided into two groups according to their blood sodium levels,hyponatremia group and non-hyponatremia group.The clinicopathological features of the two groups were compared,and the influence of blood sodium level on patient prognosis was also analyzed.Results Among the 148 patients with NENs in the digestive system,51(34.5%)were in the hyponatremia group,and 97(65.5%)in the non-hyponatremia group.The proportion of neuroendocrine carcinoma(NEC),lymph node metastasis,distant metastasis and ECOG 3-4 in hyponatremia group was significantly higher than that in non-hyponatremia group(P<0.05).The median survival of the two groups were 18 and 29 months,respectively,with significant difference(P<0.05).Multivariate analysis demonstrated that lymph node metastasis,distant metastasis and hyponatremia were independent prognostic factors affecting overall survival of patients.Conclusion The patients of NENs in the digestive system with hyponatremia have short survival time and poor prognosis,hyponatremia can be used as a predictor of poor prognosis in patients to a certain extent.