胰腺神经内分泌癌的外科治疗和预后  

Surgical treatment and prognosis of pancreatic neuroendocrine carcinoma

作　　者：张建伟[1] 车旭[1] 兰忠民[1] 陈应泰[1] 黄湘辉[1] 姜庆龙 王成锋[1] 

机构地区：[1]国家癌症中心 中国医学科学院北京协和医学院肿瘤医院腹部外科,100021

出　　处：《中华肿瘤杂志》2016年第12期925-928,共4页Chinese Journal of Oncology

基　　金：国家高技术研究发展计划（2012AA022701）

摘　　要：目的探讨外科治疗在胰腺神经内分泌癌治疗中的作用及患者的预后。方法收集2000年1月至2016年1月于中国医学科学院肿瘤医院接受根治性手术的20例胰腺神经内分泌癌患者的临床资料，采用Cox分析确定与预后相关的临床和病理因素。结果20例胰腺神经内分泌癌患者中，男性11例，女性9例，平均年龄62．5岁。20例患者均接受了根治性手术，术后17例患者使用以铂类为基础的联合化疗。全组患者的随访时间为1～127个月，1、3、5年生存率分别为66．7％、51．5％和21馏％，中位生存时间为75．3个月。多因素分析结果显示，肿瘤直径和Ki-67指数是影响胰腺神经内分泌癌患者预后的独立因素（均P〈0．05）。结论胰腺神经内分泌癌的发病率逐渐升高，但其预后不佳。局限性胰腺神经内分泌癌患者可从根治性手术中获益。早期诊断和综合治疗仍是改善胰腺神经内分泌癌患者预后的主要因素。Objective Pancreatic neuroendocrine carcinoma （pNEC） is a highly malignant tumor. This study aimed to evaluate the role of surgery and the prognosis for patients with pancreatic neuroendocrine carcinoma （pNEC）. Methods We collected and reviewed all clinical data of patients who underwent radical surgery for pNEC from Jan 2000 through Jan 2016 in our hospital. Cox-regression analysis wasused to evaluate the factors potentially influencing survival. Results Twenty patients including 11 males and 9 females （median age, 62.5 years） were included in this study. All patients underwent radical surgery and 17 cases received postoperative platinum-based chemotherapy. The median follow-up time was 41 months （range, 1 to 127 months）.The 1-, 3-, and 5-year survival rates of the patients were 66.7%, 51.5% and 28.1%, with a median survival time of 75.3 months.The multivariate analysis indicated that tumor size and Ki-67 index were of prognostic significance. Conclusions Pancreatic neuroendocrine carcinomas are rare but increasing in incidence. Patients with localized nonmetastatic primary tumors seem to benefit from surgery. Early diagnosis and muhimodality therapy are key points of an improved survival.

关 键 词：胰腺肿瘤 神经内分泌肿瘤 治疗 手术 预后 

分 类 号：R735.9[医药卫生—肿瘤]