十二指肠非壶腹区神经内分泌肿瘤的临床特征分析  

Clinical Characteristics of Non⁃ampullary Duodenal Neuroendocrine Tumors

作　　者：方洒 施育鹏 时永全 韩霜 FANG Sa;SHI Yupeng;SHI Yongquan;HAN Shuang(Department of Gastroenterology,Honghui Hospital,Xi′an Jiaotong University,Xi′an,710054;Department of Gastroenterology,the First Affiliated Hospital of Air Force Medical University,Xi′an)

机构地区：[1]西安交通大学附属红会医院消化内科,710054 [2]空军军医大学第一附属医院消化内科

出　　处：《胃肠病学》2023年第7期437-440,共4页Chinese Journal of Gastroenterology

摘　　要：背景:十二指肠神经内分泌肿瘤(DNETs)是一类罕见的肿瘤,其疾病特点仍未被清楚理解,我国目前尚无关于非壶腹区DNETs临床特征和预后的研究数据。目的:分析非壶腹区DNETs的临床特征,以期指导临床实践。方法:采用回顾性研究方法,纳入2011年6月—2022年7月于空军军医大学第一附属医院确诊或接受随访的非壶腹区DNETs患者,分析其临床病理、治疗和预后资料。结果:共22例非壶腹区DNETs患者纳入研究,其中神经内分泌瘤(NET)G112例,NET G29例,小细胞型神经内分泌癌1例,均为非功能性肿瘤。肿瘤直径<2 cm 8例,≥2 cm 14例。肿瘤直径<2 cm组确诊时半数无临床症状;肿瘤直径≥2 cm组确诊时临床症状以腹胀为主(85.7%),其次为腹痛(57.1%),仅14.3%无临床症状。至随访截止,患者中位生存时间为451.0个月,肿瘤直径<2 cm组生存时间显著长于肿瘤直径≥2 cm组[(191.25±175.47)月对(42.93±30.49)月,P=0.048]。6例死亡患者肿瘤直径均≥2 cm,其中3例为TNMⅣ期且出现肝转移。肿瘤直径<2 cm组均行内镜或外科手术治疗,术后均存活。结论:腹胀为非壶腹区DNETs患者的主要临床表现,肝脏是远处转移最易受累的器官。肿瘤直径<2 cm的患者预后相对较好。Background:Duodenal neuroendocrine tumors(DNETs)are rare tumors,and the disease characteristics are not yet fully understood.Till now,there are no research data on clinical characteristics and prognosis of non⁃ampullary DNETs in China.Aims:To analyze the clinical characteristics of patients with non⁃ampullary DNETs in order to guide clinical practice.Methods:A retrospective review of patients diagnosed as or followed up for non⁃ampullary DNETs from June 2011 to July 2022 at the First Affiliated Hospital of Air Force Medical University was performed.Data on clinical and pathological features,therapeutics,and clinical outcomes were analyzed.Results:Twenty⁃two non⁃ampullary and nonfunctional DNETs patients were enrolled in this study.Among them,12 were diagnosed as neuroendocrine tumor(NET)G1,9 were diagnosed as NET G2,and one was small cell neuroendocrine carcinoma pathologically.The tumor size was<2 cm in diameter in 8 patients,and≥2 cm in diameter in 14 patients.Half of the patients with DNETs<2 cm were diagnosed incidentally during endoscopy;while in patients with DNETs≥2 cm,the clinical symptoms were mainly abdominal distension(85.7%),followed by abdominal pain(57.1%),and only 14.3%of the patients had no clinical symptom at diagnosis.By the end of the follow⁃up,the overall median survival time was 451.0 months.The survival time of patients with DNETs<2 cm was longer than that of patients with DNETs≥2 cm[(191.25±175.47)months vs.(42.93±30.49)months,P=0.048].The tumor size was≥2 cm in diameter in all 6 death patients,among them,TNM stageⅣtumor with liver metastasis was observed in 3 cases.All patients with DNETs<2 cm underwent endoscopic or surgical resection and all survived.Conclusions:Abdominal distension is the main clinical manifestation of patients with non⁃ampullary DNETs,and distant metastasis was more likely to occur in the liver.Patients with DNETs<2 cm appear to have a favorable prognosis.

关 键 词：十二指肠 神经内分泌肿瘤 非壶腹区 临床特征 

分 类 号：R735.31[医药卫生—肿瘤]