81例老年胰腺神经内分泌肿瘤病人的临床病理特征与预后相关性分析

Correlation analysis of clinicopathologic features and prognosis in eighty-one elderly patients with pancreatic neuroendocrine tumors

目的 探讨老年胰腺神经内分泌肿瘤(pNENs)的临床病理特征和影响其预后的因素。方法 收集了2018年1月至2022年6月间在南京医科大学第一附属医院住院治疗的81例老年pNENs病人的临床病理及随访资料。采用χ~2检验进行单因素分析,采用二元Logistic回归分析评价影响pNENs预后的独立危险因素。结果 81例老年病人中,男41例,女40例;年龄60~89岁,中位年龄65岁;无功能性pNENs 68例,功能性pNENs 13例,且均为胰岛素瘤;高分化的神经内分泌瘤(NET)中G1级21例(25.93%)、G2级43例(53.09%)、G3级6例(7.41%),低分化的神经内分泌肿瘤(NEC)病人8例(9.88%),混合性神经内分泌肿瘤-非神经内分泌肿瘤(MiNEN)病人3例(3.70%)。截至2022年12月。随访时间为1~58个月,共63例病人存活,18例病人死亡。单因素分析显示,肿瘤有无功能、肿瘤分级、TNM分期以及是否手术与老年pNENs病人的总体预后相关,多因素Logistic回归分析显示肿瘤TNM分期(P=0.035)是影响pNENs预后的独立危险因素。结论 老年pNENs的TNM分期是影响预后的关键指标。

Objective To investigate the clinicopathological features and the relationship with prognosis in the elderly patients with pancreatic neuroendocrine tumors(pNENs).Methods The clinicopathological and follow-up data of 81 elderly patients with pNENs who were hospitalized in the First Affiliated Hospital of Nanjing Medical University from January 2018 to June 2022 were collected.Univariate analysis was performed usingχ2 test,and binary Logistic regression analysis was used to evaluate the independent risk factors for prognosis.Results Among the 81 elderly patients aged 60 to 89 years old(41 males and 40 females),68 cases presented with non-functional pNENs,and 13 cases presented with functional pNENs which were diagnosed as insulinoma.The pathological classification showed 21 cases(25.93%)of G1 grade,43 cases(53.09%)of G2 grade,6 cases(7.41%)of G3 grade,8 cases(9.88%)of neuroendocrine tumor(NEC)and 3 cases(3.70%)of mixed neuroendocrine-non-neuroendocrine neoplasms(MiNEN).The follow-up time ranged from 1 to 58 months.There were 18 cases of death.Single factor analysis showed that tumor function(P=0.028),tumor grade(χ2=44.387,P<0.01),TNM stage(χ2=25.980,P<0.01),surgery(P=0.002)were associated with the overall prognosis of the patients with pNENs.Logistic regression analysis indicated that tumor TNM stage(P=0.035)was the independent risk factor for the prognosis of pNENs.Conclusions Tumor TNM stage is a key indicator affecting the prognosis of the patients with pNENs.