中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2013年
10期
730-733
,共4页
夏雨人%李强%周远达%陈潞
夏雨人%李彊%週遠達%陳潞
하우인%리강%주원체%진로
胰腺肿瘤%诊断%治疗%预后
胰腺腫瘤%診斷%治療%預後
이선종류%진단%치료%예후
Pancreatic neoplasms%Diagnosis%Therapy%Prognosis
目的 探讨胰腺神经内分泌肿瘤(PanNETs)的临床病理特点、诊断、治疗以及预后.方法 回顾性分析88例PanNETs患者的临床资料,包括年龄、性别、症状、肿瘤大小、病理诊断、TNM分期、治疗以及随访情况,并探讨与预后相关的因素.结果 88例患者中,男性28例,女性60例,男女之比1∶2.1,年龄8～75岁,平均42岁.88例中无功能型74例(84.1％),功能型14例(15.9％).根据AJCC 7版TNM分期标准,本组88例中Ⅰ期23例(26.1％),Ⅱ期46例(52.3％),Ⅲ期13例(14.8％),Ⅳ期6例(6.8％).依据WHO 2000年病理分类标准,高分化神经内分泌肿瘤35例(39.8％),高分化神经内分泌癌29例(33.0％),低分化神经内分泌癌24例(27.2％).33例检测嗜铬粒蛋白A的患者中,27例(81.8％)阳性表达,41例检测突触素的患者中,38例(92.7％)阳性表达.全组患者5年总体生存率为72.0％.单因素分析显示肿瘤大小、AJCC TNM分期、病理分类、是否行根治性手术与预后相关.多因素分析显示TNM分期、病理分类以及是否行根治性手术是该组病例的独立预后影响因素.结论 PanNETs是一类低度恶性的异质性罕见肿瘤.其临床表现多样,术前误诊率高,确诊依赖病理.新版TNM分期及病理分类能积极指导预后评价.患者经积极手术或以手术为主的综合治疗可获得较好的预后.
目的 探討胰腺神經內分泌腫瘤(PanNETs)的臨床病理特點、診斷、治療以及預後.方法 迴顧性分析88例PanNETs患者的臨床資料,包括年齡、性彆、癥狀、腫瘤大小、病理診斷、TNM分期、治療以及隨訪情況,併探討與預後相關的因素.結果 88例患者中,男性28例,女性60例,男女之比1∶2.1,年齡8～75歲,平均42歲.88例中無功能型74例(84.1％),功能型14例(15.9％).根據AJCC 7版TNM分期標準,本組88例中Ⅰ期23例(26.1％),Ⅱ期46例(52.3％),Ⅲ期13例(14.8％),Ⅳ期6例(6.8％).依據WHO 2000年病理分類標準,高分化神經內分泌腫瘤35例(39.8％),高分化神經內分泌癌29例(33.0％),低分化神經內分泌癌24例(27.2％).33例檢測嗜鉻粒蛋白A的患者中,27例(81.8％)暘性錶達,41例檢測突觸素的患者中,38例(92.7％)暘性錶達.全組患者5年總體生存率為72.0％.單因素分析顯示腫瘤大小、AJCC TNM分期、病理分類、是否行根治性手術與預後相關.多因素分析顯示TNM分期、病理分類以及是否行根治性手術是該組病例的獨立預後影響因素.結論 PanNETs是一類低度噁性的異質性罕見腫瘤.其臨床錶現多樣,術前誤診率高,確診依賴病理.新版TNM分期及病理分類能積極指導預後評價.患者經積極手術或以手術為主的綜閤治療可穫得較好的預後.
목적 탐토이선신경내분비종류(PanNETs)적림상병리특점、진단、치료이급예후.방법 회고성분석88례PanNETs환자적림상자료,포괄년령、성별、증상、종류대소、병리진단、TNM분기、치료이급수방정황,병탐토여예후상관적인소.결과 88례환자중,남성28례,녀성60례,남녀지비1∶2.1,년령8～75세,평균42세.88례중무공능형74례(84.1％),공능형14례(15.9％).근거AJCC 7판TNM분기표준,본조88례중Ⅰ기23례(26.1％),Ⅱ기46례(52.3％),Ⅲ기13례(14.8％),Ⅳ기6례(6.8％).의거WHO 2000년병리분류표준,고분화신경내분비종류35례(39.8％),고분화신경내분비암29례(33.0％),저분화신경내분비암24례(27.2％).33례검측기락립단백A적환자중,27례(81.8％)양성표체,41례검측돌촉소적환자중,38례(92.7％)양성표체.전조환자5년총체생존솔위72.0％.단인소분석현시종류대소、AJCC TNM분기、병리분류、시부행근치성수술여예후상관.다인소분석현시TNM분기、병리분류이급시부행근치성수술시해조병례적독립예후영향인소.결론 PanNETs시일류저도악성적이질성한견종류.기림상표현다양,술전오진솔고,학진의뢰병리.신판TNM분기급병리분류능적겁지도예후평개.환자경적겁수술혹이수술위주적종합치료가획득교호적예후.
Objective To analyze the clinicopathological characteristics,diagnosis,treatment outcomes and prognosis of patients with pancreatic neuroendocrine tumors (PanNETs).Methods The clinicopathological characteristcs and prognostic factors of 88 patients who were diagnosed with pancreatic neuroendocrine tumors by postoperative pathology were analyzed retrospectively.The data included age,sex,symptoms,tumor size,pathological grades,TNM staging,treatment and follow up.Results There were 28 males and 60 females.The ratio of male to female was 1 ∶ 2.1,with a mean age of 42 (range 8～75) years.Of the 88 PanNETs,74(84.1％) were nonfunctional tumors.Using the WHO 2000 pathological classification system,there were 35 well differentiated endocrine tumors (WDET),29 well differentiated endocrine carcinomas (WDEC),and 24 poorly differentiated endocrine carcinomas (PDEC).Using the 7th AJCC TNM staging system,23(26.1％),46(52.3％),13(14.8％) and 6 patients (6.8％) were diagnosed to have stage Ⅰ,Ⅱ,Ⅲ and Ⅳ,respectively.The overall 5-year survival rate was 72.0 ％.Univariable analysis revealed tumor size,histopathological grades,TNM staging and radical surgery were associated with prognosis.Multivariate analysis showed histopathological grades,TNM staging and radical surgery were independent risk factors of survival.Conclusions PanNETs are rare pancreatic neoplasms with high heterogeneity and low malignant potential.PanNETs have various clinical manifestations and the preoperative misdiagnosis rate is high.A definitive diagnosis depends on pathological examination.The new TNM and pathological classification systems have good predictive abilities on survival.The majority of patients who received radical surgery or surgical comprehensive therapy have good prognosis.
