中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2013年
9期
784-787
,共4页
张人超%牟一平%徐晓武%严加费%陈其龙
張人超%牟一平%徐曉武%嚴加費%陳其龍
장인초%모일평%서효무%엄가비%진기룡
胰腺肿瘤%神经内分泌瘤%外科手术%预后
胰腺腫瘤%神經內分泌瘤%外科手術%預後
이선종류%신경내분비류%외과수술%예후
Pancreatic neoplasms%Neuroendocrine tumors%Surgical procedures,operative%Prognosis
目的 探讨影响胰腺神经内分泌肿瘤患者预后的因素.方法 回顾性分析1995年3月至2012年12月61例胰腺神经内分泌肿瘤患者临床资料.其中男性23例,女性38例；年龄22～68岁,中位年龄52岁.无功能性肿瘤41例,功能性肿瘤20例.59例接受手术治疗,其中13例行腹腔镜手术；2例行CT引导下胰腺肿块活检术.采用Kaplan-Meier法对患者生存情况进行分析.结果 61例患者中,53例(86.9％)行根治性手术.肿瘤分级:G1、G2、G3级分别为41例(67.2％)、9例(14.8％)、11例(18.0％). TNM分期:Ⅰ、Ⅱ、Ⅲ、Ⅳ期分别为47例(77.0％)、7例(11.5％)、2例(3.3％)、5例(8.2％).肝转移5例,神经侵犯5例.随访3 ～ 209个月,中位随访时间40个月.1、3、5年生存率分别为92.0％、89.7％、86.3％.单因素生存分析示:肿瘤分级(x2=18.503)、TNM分期(x2=23.401)、肝转移(x2=18.606)、神经侵犯(x2=10.091)、手术性质(x2=25.514)与预后相关(P =0.000).结论 胰腺神经内分泌肿瘤患者手术切除可获得长期生存.新的WHO分级、TNM分期、手术性质可以比较有效地预测肿瘤的预后.肝转移、神经侵犯提示预后不佳.
目的 探討影響胰腺神經內分泌腫瘤患者預後的因素.方法 迴顧性分析1995年3月至2012年12月61例胰腺神經內分泌腫瘤患者臨床資料.其中男性23例,女性38例；年齡22～68歲,中位年齡52歲.無功能性腫瘤41例,功能性腫瘤20例.59例接受手術治療,其中13例行腹腔鏡手術；2例行CT引導下胰腺腫塊活檢術.採用Kaplan-Meier法對患者生存情況進行分析.結果 61例患者中,53例(86.9％)行根治性手術.腫瘤分級:G1、G2、G3級分彆為41例(67.2％)、9例(14.8％)、11例(18.0％). TNM分期:Ⅰ、Ⅱ、Ⅲ、Ⅳ期分彆為47例(77.0％)、7例(11.5％)、2例(3.3％)、5例(8.2％).肝轉移5例,神經侵犯5例.隨訪3 ～ 209箇月,中位隨訪時間40箇月.1、3、5年生存率分彆為92.0％、89.7％、86.3％.單因素生存分析示:腫瘤分級(x2=18.503)、TNM分期(x2=23.401)、肝轉移(x2=18.606)、神經侵犯(x2=10.091)、手術性質(x2=25.514)與預後相關(P =0.000).結論 胰腺神經內分泌腫瘤患者手術切除可穫得長期生存.新的WHO分級、TNM分期、手術性質可以比較有效地預測腫瘤的預後.肝轉移、神經侵犯提示預後不佳.
목적 탐토영향이선신경내분비종류환자예후적인소.방법 회고성분석1995년3월지2012년12월61례이선신경내분비종류환자림상자료.기중남성23례,녀성38례；년령22～68세,중위년령52세.무공능성종류41례,공능성종류20례.59례접수수술치료,기중13례행복강경수술；2례행CT인도하이선종괴활검술.채용Kaplan-Meier법대환자생존정황진행분석.결과 61례환자중,53례(86.9％)행근치성수술.종류분급:G1、G2、G3급분별위41례(67.2％)、9례(14.8％)、11례(18.0％). TNM분기:Ⅰ、Ⅱ、Ⅲ、Ⅳ기분별위47례(77.0％)、7례(11.5％)、2례(3.3％)、5례(8.2％).간전이5례,신경침범5례.수방3 ～ 209개월,중위수방시간40개월.1、3、5년생존솔분별위92.0％、89.7％、86.3％.단인소생존분석시:종류분급(x2=18.503)、TNM분기(x2=23.401)、간전이(x2=18.606)、신경침범(x2=10.091)、수술성질(x2=25.514)여예후상관(P =0.000).결론 이선신경내분비종류환자수술절제가획득장기생존.신적WHO분급、TNM분기、수술성질가이비교유효지예측종류적예후.간전이、신경침범제시예후불가.
Objective To analyze the prognostic factors of pancreatic neuroendocrine neoplasms (PNEN).Methods Clinical data of 61 patients with PNEN from March 1992 to December 2012 was retrospectively analyzed.There were 23 male and 38 female patients,with a median age of 52 years (ranged from 22 to 68 years).Forty-one patients were non-functional tumors,and 20 patients were functional tumors.Fifty-nine patients received operation,13 (22.0％) patients underwent laparoscopic operation,2 patients underwent puncture biopsy under CT guidance.Survival was analyzed with the Kaplan-Meier method.Results Among these patients,53 (86.9％) patients underwent curative resection.The cases of grade G1,G2,G3 were 41 (67.2％),9 (14.8％),11 (18.0％),respectively.The cases of stage Ⅰ,Ⅱ,Ⅲ,Ⅳ were 47 (77.0％),7 (11.5％),2 (3.3％),5 (8.2％),respectively.Liver metastasis,neural invasion were found in 5 cases (8.2％),5 cases (8.2％),respectively.The median follow-up period was 40 months (ranged from 3 to 209 months).The overall 1-,3-,5-year survival rates were 92.0％,89.7％,86.3％,respectively.Univariate analysis showed WHO classification (x2 =18.503),TNM staging system (x2 =23.401),liver metastasis (x2 =18.606),neural invasion (x2 =10.091),resection status (x2 =25.514) were prognostic factors of PNEN (all P =0.000).Conclusions Surgical resection in PNEN results in long-term survival.WHO classification,TNM staging,resection status are effective in predicting the prognosis of PNEN.Liver metastasis,neural invasion predicted poor prognosis.
