不同年龄胃肠胰神经内分泌肿瘤患者预后分析  

Prognostic analysis of patients with gastroenteropancreatic neuroendocrine neoplasms at different ages

作　　者：杨欢 王晓坤 石素胜[2] 蒋力明 依荷芭丽·迟 范金虎 乔友林 Huan Yang;Xiaokun Wang;Susheng Shi;Liming Jiang;Yihebali·Chi;Jinhu Fan;Youlin Qiao(Department of Epidemiology,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Department of Pathology,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Department of Diagnostics,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Department of Medical Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院流行病室,北京市100021 [2]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院病理科,北京市100021 [3]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院诊断科,北京市100021 [4]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院内科,北京市100021

出　　处：《中国肿瘤临床》2022年第15期792-796,共5页Chinese Journal of Clinical Oncology

摘　　要：目的:本研究旨在描述中国不同诊断年龄胃肠胰神经内分泌肿瘤(gastroenteropancreatic neuroendocrine neoplasms,GEPNENs)患者的临床病理特征和治疗信息,探讨诊断年龄与术后5年生存率之间的关系。方法:作为一项以医院为基础的全国多中心临床流行病学研究,本研究回顾性收集了2001年1月至2010年12月在研究医院就诊的GEP-NENs患者的病历信息和术后生存情况。采用Cox风险比例回归模型估计研究对象的术后死亡风险比和95%可信区间(95%CI)。结果:共2002例患者被纳入最终分析。患者按照诊断年龄分为≤50岁组和>50岁组。术后5年生存数据分析显示,与年龄≤50岁的患者相比,年龄>50岁的患者术后死亡风险显著增加(HR=2.83,95%CI:1.87~4.28)。在调整了原发部位、功能状态、TNM分期、分级、肿瘤浸润和转移情况、放化疗、靶向治疗和生物治疗情况后,不同年龄组之间的死亡风险差异无统计学意义(HR=1.63,95%CI:0.98~2.72)。对性别亚组进行多因素分析结果显示,在男性患者中,年龄>50岁组患者术后死亡风险显著增加(HR=2.65,95%CI:1.28~5.47)。结论:不同年龄组GEP-NENs患者的临床病理特征和治疗方式选择存在差异,但年龄不是GEP-NENs患者预后的独立影响因素,提示对于诊断年龄不同的患者,临床医生应根据现有临床实践指南及患者个体情况,选择精准治疗方案。Objective:To assess clinicopathological features and treatment options of patients with gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)at different ages and explore associations between age and five-year survival rate after surgery.Methods:In this hospital-based,nationwide,multicenter clinical epidemiological study,we retrospectively collected medical and survival data after surgery from 2,010 patients with GEP-NENs enrolled in the study hospitals from January 2001 to December 2010.The Cox proportional hazard model was used to estimate the hazard ratio(HR)and 95%confidence interval(95%CI)to determine the risk for death after surgery.Results:The patients were assigned into two groups based on their age at diagnosis:≤50 years and>50 years.Analysis of the five-year survival data after surgery revealed that the risk for death was significantly higher in patients aged>50 years than in those aged≤50 years(HR=2.83,95%CI:1.87-4.28).After adjusting for primary sites,TNM stage,tumor grade,depth of invasion,lymph node metastasis and distant metastasis status,chemoradiotherapy,target therapy,and biotherapy,all HRs were not statistically significant(All P>0.05).Subgroup multivariate analysis according to sex showed that patients aged>50 years had significantly increased risks for death among male patients.Conclusions:Differences were noted in clinicopathological characteristics and treatment options of patients with GEP-NENs in different age groups.The five-year survival rate of patients with GEP-NENs aged>50 years is low,but age at diagnosis is not an independent factor affecting prognosis,indicating that according to the current clinical practice guidelines for GEP-NENs,precise and personalized treatment should be selected for patients with different ages at diagnosis.

关 键 词：诊断年龄 胃肠胰神经内分泌肿瘤 临床病理特征 治疗 5 年生存率 

分 类 号：R735[医药卫生—肿瘤]