非功能型胰腺神经内分泌肿瘤手术预后分析——一项基于SEER数据库的回顾性研究  

Prognostic Factors of Long-term Outcome of Non-functional Pancreatic Neuroendocrine Neoplasms Following Surgical Treatment:A Retrospective Study Based on SEER Database

作　　者：冯婷婷[1] 凌孙彬[2] 刘碧霞[1] 赵亚珍[1] 王小红[1] 吕汪霞[1] 袁梅琴[1] 史钟[1] 杨云山[1] 钟海均[1] 朱利明[1] 

机构地区：[1]浙江省肿瘤医院,浙江杭州310022 [2]浙江大学附属第一医院,浙江杭州310003

出　　处：《中国肿瘤》2017年第11期910-914,共5页China Cancer

基　　金：中国临床肿瘤科学基金(Y-N2014-012);浙江省医药卫生科研基金项目(2017190526)

摘　　要：[目的]基于SEER数据库分析经手术治疗的非功能型胰腺神经内分泌肿瘤预后相关因素,以对临床决策提供参考。[方法]通过美国SEER*Stat软件搜集1990~2011年病理明确诊断为非功能型胰腺神经内分泌肿瘤并接受原发灶切除手术的病例共418例。单因素和多因素Cox回归分析患者预后的影响因素。[结果]经Cox单因素分析,肿瘤大小、病理类型、分期、分化程度、是否合并淋巴结转移、手术范围及围手术期放疗的P值小于0.05,年龄及性别的P值分别为0.080及0.086,其余如诊断年份、种族、肿瘤位置P值均大于0.05。将经单因素分析所得P值小于0.1的因素均纳入Cox多因素回归分析,其中年龄、肿瘤大小及诊断年份均以连续变量带入多因素分析。结果显示年龄(HR=1.041,P=0.008)、肿瘤大小(HR=1.008,P=0.003)、性别(与女性相比,男性HR=1.656,P=0.029)、病理分化程度(总体P=0.001,与Ⅰ级组相比,Ⅱ级组HR=1.799,P=0.042,Ⅲ级组HR=4.624,P<0.001)、分期(总体P<0.001,与局限期相比,区域转移组HR=2.337,P=0.017;远处转移组HR=4.357,P=0.010)、手术切除范围(总体P=0.01,与局限切除组相比,全胰腺切除组HR=1.053,P=0.903,Whipple组HR=1.924,P=0.012)均为非功能型胰腺神经内分泌肿瘤手术预后的独立影响因素。[结论 ]高龄、肿瘤较大、男性、低分化、分期较晚、手术切除范围较大为非功能型胰腺神经内分泌肿瘤手术预后的独立危险因素。[Purpose] To investigate the prognostic factors of long-term outcome in surgically resectable non-functional pancreatic neuroendocrine tumors（Pan-NENs ） based on Surveillance,Epidemiology,and End Results（SEER） database. [Methods] Patients with non-functional Pan-NENs registered in SEER database between 1990 and 2011 were identified,and those undergoing primary resection were included in the study. Cancer-specific survival of patients was analyzed,and the prognostic factors were determined by Cox univariate and multivariate analyses. [Results] Cox univariate regression analysis showed that the significant factors associated with overall survival rate were tumor size,the type of tumor,stage,grade,lymph node status,surgery type and perioperative radiotherapy（P〈0.05）. Above factors,along with age（P〈0.080） and gender（P〈0.086） entered Cox multivariate regression analysis. The multivariate regression analysis showed that age（HR=1.041,P=0.008）,tumor size（HR=1.008,P=0.003）,gender（male HR=1.656,P=0.029）,graded（overall P=0.001; compared with grade Ⅰ,for grade Ⅱ HR=1.799,P=0.042,for grade Ⅲ HR=4.624,P〈0.001 ）,stage（overall P〈0.001; compared to non-metastasis,for regional metastasis HR=2.337,P=0.017; for distant metastasis HR=1.353,P=0.010）,surgery type（overall P=0.01,compared to local resection,for total pancreatectomy HR=1.053,P=0.903,for Whipple surgery HR=1.924,P=0.012 ） were the independent prognostic factors of non-functional Pan-NENs. [Conclusion] Older age,larger tumor size,male gender,poor differentiation,late stage and extensive surgical resection are significant prognostic risk factors of non-functional Pan-NENs following surgical treatment.

关 键 词：非功能型胰腺神经内分泌肿瘤 外科手术 预后 

分 类 号：R730[医药卫生—肿瘤]