胆道神经内分泌肿瘤29例临床病理特征分析  

CLINICOPATHOLOGICAL FEATURES OF BILIARY NEUROENDOCRINE NEOPLASM:AN ANALYSIS OF 29 CASES

作　　者：包文慧 江月萍[1] 马昕[1,2] 杨婷 BAO Wenhui;JIANG Yueping;MA Xin;YANG Ting(Department of Gastroenterology,Laoshan Campus,The Affiliated Hospital of Qingdao University,Qingdao 266100,China)

机构地区：[1]青岛大学附属医院崂山院区消化内科,山东青岛266100 [2]青岛大学医学部

出　　处：《精准医学杂志》2022年第3期270-274,共5页Journal of Precision Medicine

基　　金：山东省自然科学基金(ZR2020MH059)。

摘　　要：目的总结胆道神经内分泌肿瘤的临床病理特征及其预后影响因素。方法对2013年1月1日—2021年12月31日青岛大学附属医院收治的胆道神经内分泌肿瘤患者的临床资料进行回顾性研究,利用Kaplan-Meier法进行生存分析。结果共纳入患者29例,男16例,女13例;年龄34~78岁,中位年龄60岁。肿瘤位于胆囊14例,胆管9例,肝胰壶腹6例。胆囊肿瘤患者无突出症状,胆管和壶腹肿瘤患者常表现为腹痛和黄疸。病理分型示NET G_(1)级1例,G_(2)级2例,G_(3)级2例,NEC 14例,MiNEN 10例。TNM分期示Ⅰ期5例,Ⅱ期9例,Ⅲ期11例,Ⅳ期4例。淋巴结转移10例,肝转移8例,多见于NEC与MiNEN。患者1、2年累积生存率分别为75.5%、45.0%,中位生存期19个月。年龄<65岁、肿瘤直径<2 cm、非NET肿瘤、TNM分期的Ⅲ/Ⅳ期、合并转移、肿瘤复发的患者生存期呈缩短趋势。结论胆道神经内分泌肿瘤根据肿瘤位置有不同的临床表现,病理分型以NEC和MiNEN为主,肿瘤淋巴结、肝脏转移率高,患者预后差。发病年龄、肿瘤大小、病理分类、是否手术及肿瘤是否复发可能是影响患者预后的危险因素。Objective To investigate the clinicopathological features of biliary neuroendocrine neoplasm and the influencing factors for prognosis.Methods A retrospective analysis was performed for the clinical data of the patients with biliary neuroendocrine neoplasm who were admitted to The Affiliated Hospital of Qingdao University from January 1,2013 to December 31,2021,and the Kaplan-Meier method was used for survival analysis.Results A total of 29 patients(16 male patients and 13 female patients)were included in the study,with a median age of 60 years(range 34-78 years).Among the 29 patients,14 had tumor in the gallbladder,9 had tumor in the bile duct,and 6 had tumor in the ampulla of Vater.The patients with gallbladder tumor had no prominent symptoms,and those with bile duct and ampullary tumors had the manifestation of abdominal pain and jaundice.Pathological typing showed NET G_(1)in 1 patient,NET G_(2)in 2 patients,NET G_(3)in 2 patients,NEC in 14 patients,and MiNEN in 10 patients,and TNM staging showed stageⅠtumor in 5 patients,stageⅡtumor in 9 patients,stageⅢtumor in 11 patients,and stageⅣtumor in 4 patients.There were 10 patients with lymph node metastasis and 8 patients with liver metastasis,which was more common in the patients with NEC or MiNEN.The 1-and 2-year cumulative survival rates were 75.5%and 45.0%,respectively,and the median survival time was 19 months.The patients with an age of<65 years,a tumor diameter of<2 cm,non-NET tumor,TNM stageⅢ/Ⅳtumor,metastasis,and tumor recurrence tended to have a shorter survival time.Conclusion The clinical manifestations of biliary neuroendocrine neoplasm vary based on tumor location.NEC and MiNEN are the main pathological types,and there are high rates of lymph node metastasis and liver metastasis.Patients tend to have a poor prognosis.Age of onset,tumor size,pathological classification,surgery,and presence or absence of tumor recurrence may be the inf-luencing factors for prognosis.

关 键 词：神经内分泌瘤 胆囊肿瘤 胆管肿瘤 肝胰管壶腹 病理学 临床 免疫组织化学 预后 

分 类 号：R730.264[医药卫生—肿瘤] R735.8[医药卫生—临床医学]