Analysis of diagnosis, therapy and prognosis factors of 103 patients with pancreatic neuroendocrine tumors / 中华外科杂志

ABSTRACT

Objective@#To discuss the clinical pathology characteristics, strategies of diagnosis and therapy, and related prognosis factors of pancreatic neuroendocrine tumors(pNET).@*Methods@#Clinical data of 103 pNET cases in Department of Pancreatic Surgery, Changhai Hospital of Second Military Medical University were collected from January 2006 to December 2015. There were 44 males and 59 females, aged from 21 to 77 years with mean age of 48 years.Of the 103 patients, there were functional type in 21 cases and no functional type in 82 cases. Related factors on diagnosis and treatment were summarized. Moreover, univariate survival analysis was performed by Kaplan-Meier method, and COX proportional hazards model was used for multivariate survival analysis.@*Results@#The detection rates of the B-ultrasound, CT, MRI were 60.2%, 84.6% and 91.3%, respectively, and there were 44 cases located in pancreatic head, 18 cases in pancreatic neck and 41 cases in pancreatic body and tail.G1 was the most common pathological grade, and the positive rates of Chromogranin A, Syn, neuron-specific enolase and CAM5.2 were 97.1%, 97.1%, 91.3% and 93.2%, respectively. The results of statistical analysis showed that tumor grade(χ2=26.077, P<0.05), Ki-67 index(χ2=25.427, P<0.05), ENETS stage(χ2=5.915, P<0.05), AJCC stage(χ2=8.411, P<0.05), lymph node metastasis(χ2=4.770, P<0.05) and distant metastasis(χ2=8.411, P<0.05) were associated with the prognosis of pNET, and the tumor grade was an independent risk factor of the pNET′ overall prognositic factors (HR=3.085, P<0.01).@*Conclusions@#The pNET can be located in any part of pancreas, and the combination of laboratory and various imaging examinations can help make early diagnosis. In addition, tumor grade, Ki-67 index, ENETS stage, AJCC stage, lymph node metastasis and distant metastasis were closely related to the prognosis of pNET, and the higher the tumor grade, the worse the prognosis.