胆囊神经内分泌肿瘤32例分析  

Outcomes of 32 patients with gallbladder neuroendocrine neoplasm

作　　者：吴昕[1] 李秉璐[1] 郑朝纪[1] 何小东[1] 刘卫[1] 洪涛[1] WU Xin;LI Bing-lu;ZHENG Chao-ji(Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院基本外科,北京100730

出　　处：《中国实用外科杂志》2023年第11期1267-1271,共5页Chinese Journal of Practical Surgery

基　　金：中国医学科学院医学与健康科技创新工程项目(No.2022-I2M-C&T-A-004);中央高水平医院临床科研专项(No.2022-PUMCH-B-005)。

摘　　要：目的 探讨胆囊神经内分泌肿瘤的诊治方式和外科手术后的治疗效果。方法 回顾性分析北京协和医院2012年1月至2023年2月收治的32例胆囊神经内分泌肿瘤病人的临床资料。根据获得随访病人的预后不同,比较分析生存与死亡病例的临床及预后资料。结果 32例病人中,27例接受手术切除治疗,3例接受手术活检,2例接受肝穿刺活检。有4例病人发生术后并发症,其中Clavien-Dindo分级Ⅰ级和Ⅱ级各2例。所有病人均顺利出院,住院时间(12.0±6.0)d。在接受手术切除治疗的27例病人中,神经内分泌瘤5例,神经内分泌癌15例,混合性腺神经内分泌癌7例。截至2023年7月,31例病人获得随访,1例失访。中位随访时间为13(8,29)个月。31例获得随访病人的1、2和3年累积总体生存率分别为72.5%、53.4%和48.1%;26例接受手术切除治疗病人的1、2和3年累积总体生存率分别为80.1%、57.8%和52.0%。31例获得随访病人的1年累积无瘤生存率为40.0%。接受手术切除治疗的病人中,死亡病人的Ki-67指数高于生存病人(P=0.039)。结论 胆囊神经内分泌肿瘤的主要治疗方式是手术,总体预后欠佳。Ki-67指数与预后可能有关。Objective To investigate the clinical features,treatment strategy,and surgical outcomes of gallbladder neuroendocrine neoplasm.Methods The data of 32 gallbladder neuroendocrine neoplasm patients admitted at Peking Union Medical College Hospital between January 2012 and February 2023 were analyzed retrospectively.The differences between survival patients and dead patients were compared.Results Among the 32 patients,27 underwent operation,3 underwent surgical biopsy,and 2 underwent liver puncture biopsy.Four patients had postoperative complications,with 2 cases each of grade I and II according to the Clavien-Dindo system.All patients were discharged smoothly,with a mean hospital stay of(12.0±6.0) days.Among the 27 patients who underwent operation,there were 5neuroendocrine tumors,15 neuroendocrine carcinomas,and 7 mixed endocrine non-endocrine neoplasms.As of July2023,31 patients were followed up and 1 patient was lost.The median follow-up time was 13(8,29) months.The cumulative 1-,2-and 3-year overall survival rates of 31 patients were 72.5%,53.4%,and 48.1%,respectively.The cumulative 1-,2-,and 3-year overall survival rates of 26 patients who underwent operation were 80.1%,57.8%,and52.0%,respectively.The cumulative 1-year disease-free survival rate of 31 patients was 40.0%.In patients who underwent operation,the Ki-67 index in the dead patients was significantly higher than that in the survival patients(P=0.039).Conclusion The main treatment of gallbladder neuroendocrine neoplasm is surgery,and the overall prognosis is poor.Ki-67 index is associated with prognosis.

关 键 词：胆囊肿瘤 神经内分泌肿瘤 预后 累积生存率 

分 类 号：R6[医药卫生—外科学]