无功能性胰腺神经内分泌肿瘤的临床诊治分析  

Analysis of Clinical Diagnosis and Treatment of Nonfunctional Pancreatic Neuroendocrine Neoplasms

作　　者：李婧[1] 王琳[1] 康强[1] 李越华[1] 朱红[1] 陈怡璇 雷学芬 LI Jing;WANG Lin;KANG Qiang;LI Yuehua;ZHU Hong;CHEN Yixuan;LEI Xuefen(Dept.of Hepatopancreatobiliary Surgery,The 2nd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101,China;Dept.of Oncology,The 2nd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101,China)

机构地区：[1]昆明医科大学第二附属医院肝胆胰外科,云南昆明650101 [2]昆明医科大学第二附属医院肿瘤科,云南昆明650101

出　　处：《昆明医科大学学报》2023年第7期47-51,共5页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81860423);云南省科技厅-昆明医科大学应用基础研究联合专项基金面上项目(2019FE001-071)。

摘　　要：目的探讨手术切除对无功能性胰腺神经内分泌肿瘤(nonfunctioning pancreatic neuroendocrine neoplasms,NF-pNENs)患者预后的影响。方法回顾性分析2011年1月至2020年12月就诊于昆明医科大学第二附属医院的45例经术后病理确诊为NF-pNENs患者的临床及随访资料。结果随访时间为6~112个月,中位随访时间47个月,获得随访的患者有43例,术后有1例复发、2例远处转移,存活40例,死亡3例,1例分化良好的G2患者术后83个月因全身多发转移死亡,2例分化差的G3患者于术后6个月死亡。NF-pNENs患者术后5 a生存率为95.3%。结论手术作为目前唯一能治愈pNENs的手段,在专业的胰腺中心是可行的,术前明确WHO分级和淋巴结是否转移有利于手术方式的选择,术中需要进行规范的淋巴结清扫获得足够数目的淋巴结来明确转移情况,才能更好地指导预后评价。Objective To investigate the prognosis of surgical resection in patients with nonfunctioning pancreatic neuroendocrine neoplasms(NF-pNENs).Methods The clinical and follow-up data of 45 patients who were pathologically confirmed NF-pNENs in the Second Affiliated Hospital of Kunming Medical University from January 2011 to December 2020 were retrospectively analyzed.Results The follow-up time was 6 to 112 months,and the median follow-up time was 47 months.A total of 43 patients were followed up.Postoperative recurrence occurred in 1 case,distant metastasis in 2 cases,40 cases survived,and 3 cases died,one well-differentiated G2 patient died 83 months after surgery due to multiple systemic metastasis,and two poorly differentiated G3 patients died 6 months after surgery.The 5-year postoperative survival rate of patients with NF-pNENs was 95.3%.Univariate analysis showed that the tumor WHO grade and lymph node metastasis were related to the prognosis of NF-pNENs patients,and the difference was statistically significant(P<0.05).Multivariate analysis did not suggest independent factors affecting the prognosis of NF-pNENs.Conclusions Surgery is the only cure for pNENs currently,which is available in specialized pancreatic centers.Preoperative identification of WHO grade and lymph node metastasis is conducive to the choice of surgical mode.Standard intraoperative lymph node dissection is required to obtain a sufficient number of lymph nodes to clarify the metastasis,so as to better guide the prognostic evaluation.

关 键 词：胰腺神经内分泌肿瘤 手术 疗效 

分 类 号：R735.9[医药卫生—肿瘤]