临床外科杂志 ›› 2022, Vol. 30 ›› Issue (2): 166-170.doi: 10.3969/j.issn.1005-6483.2022.02.021

• 论著 • 上一篇    下一篇

胃肠胰神经内分泌肿瘤临床治疗及预后分析

  

  1. 710032 西安,中国人民解放军空军军医大学第一附属医院消化外科
  • 收稿日期:2021-06-25 接受日期:2021-06-25 出版日期:2022-02-20 发布日期:2022-02-20
  • 通讯作者: 李纪鹏,Email:jipengli1974@aliyun.com
  • 基金资助:
    陕西省社发公关基金资助项目(2020SF-229)

Clinical treatment and prognostic analysis of gastrointestinal pancreatic neuroendocrine neoplasm

  1. Department of Digestive Surgery,the First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032, China
  • Received:2021-06-25 Accepted:2021-06-25 Online:2022-02-20 Published:2022-02-20

摘要: 目的 分析胃肠胰神经内分泌肿瘤(GEP-NENs)发病特点及影响预后的危险因素。 方法 2009年1月~2016年12月我院住院治疗的GEP-NENs病人108例,随访36个月,分析其临床特征、病理特点。采用单因素分析和多因素Cox回归分析研究影响生存率的预后因素,Kaplan-Meier法进行生存分析。 结果 患病男女比为1.16∶1,平均年龄(50.90±12.94)岁。好发部位依次为胰腺、直肠、胃体。肿瘤直径最小0.2-cm,最大13.2-cm,平均(1.90±1.94)cm。病理分类:神经内分泌瘤占88.9%,神经内分泌癌占11.1%。病理分级:G1级占52.8%、G2级占36.1%、G3级占11.1%。其中95.4%的病人进行了手术治疗,69.9%行根治性手术切除。随访3年总生存率为87.1%。单因素分析显示,病理类型、分级、临床分期、非功能性肿瘤、肿瘤直径、Ki-67指数、淋巴结转移以及远处转移是影响GEP-NENs病人预后的危险因素(P<0.05)。多因素分析显示,肿瘤直径及淋巴结转移是影响GEP-NENs病人预后的独立危险因素。结论 GEP-NENs病人预后与病理类型、分级、临床分期、非功能性肿瘤、肿瘤直径、Ki-67指数、淋巴结转移以及远处转移有关。肿瘤直径和淋巴结转移是影响病人预后的独立危险因素。

关键词: 胃肠胰神经内分泌肿瘤, 临床及病理特征, 治疗, 预后

Abstract: Objective To analyze the characteristics of gastrointestinal pancreatic neuroendocrine neoplasm(GEP-NENs) and the risk factors that affect the prognosis of patients. Methods The clinical data and 36 month follow-up data of 108 patients with GEP-NENs who were hospitalized in the First Affiliated Hospital of Air Force Military Medical University from January 2009 to December 2016 were collected.Analyze its clinical characteristics,pathological characteristics and other indicators.Univariate and multivariate Cox regression models were used to study the prognostic factors affecting survival,and Kaplan-Meier method was used for survival analysis. Results The ratio of male to female was 1.16∶1,and the average age was (50.90±12.94) years.The predominant sites were pancreas,rectum,and stomach.The tumor diameter ranged from 0.2cm to 13.2cm,with a mean of (1.90±1.94)cm.Pathological classification:neuroendocrine tumor accounted for 88.9% and neuroendocrine carcinoma 11.1%.Pathological grade:G1 grade accounted for 52.8%,G2 grade accounted for 36.1%,and G3 grade accounted for 11.1%.Among them,95.4% of patients underwent surgical treatment,and 69.9% underwent radical surgical resection.The 3year overall survival rate was 87.1%.Univariate analysis of pathological type,grade,clinical stage,nonfunctional tumor,tumor diameter,Ki67 index,lymph node metastasis and distant metastasis are important factors affecting the prognosis of GEP-NENs patients(P<0.05).Multivariate analysis showed that tumor size and lymph node metastasis were independent risk factors affecting the prognosis of patients with GEP-NENs.Conclusion The prognosis of patients with GEP-NENs is related to pathological type,grade,clinical stage,non-functional tumor,tumor diameter,Ki-67 index,lymph node metastasis and distant metastasis.Tumor size and lymph node metastasis are independent risk factors that affect the prognosis of patients.

Key words: gastrointestinal pancreatic neuroendocrine neoplasm, pathological feature, treatment, prognosis

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