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目的探讨经病理证实的胰腺神经内分泌肿瘤预后及其相关因素。方法收集1999年1月至2014年7月间收治的71例胰腺神经内分泌肿瘤的临床资料,进行随访及统计学分析。结果非功能性肿瘤65例,主要表现为腹痛、腹胀、腹部肿块等,其中23例无明显症状;功能性肿瘤6例,以内分泌紊乱症状为特点,4例以低血糖反应为主要表现。71例患者中,65例接受手术治疗;另6例保守治疗。随访时间为1~184个月,中位随访时间为41个月。45例存活,其中40例未见肿瘤复发,5例出现远处转移,16例死亡,7例失访。单因素分析结果显示,手术方式(2=8.433)、肿瘤分级(2=7.685)、肿瘤分期(2=15.204)、有无淋巴结转移(2=8.508)、有无神经侵犯(2=14.531)和有无远处转移(2=1.060)与预后相关。多因素分析结果显示,有无神经侵犯是影响胰腺神经内分泌肿瘤预后的独立因素。结论手术方式、肿瘤分级、肿瘤分期、淋巴结转移情况、神经侵犯情况和有无远处转移均可影响胰腺神经内分泌肿瘤的预后,有神经侵犯则提示预后不良。
Objective To investigate the prognosis of pancreatic neuroendocrine tumors confirmed by pathology and its related factors. Methods The clinical data of 71 cases of pancreatic neuroendocrine tumors collected from January 1999 to July 2014 were collected and followed up and analyzed statistically. Results There were 65 cases of non-functional tumors, mainly abdominal pain, abdominal distension and abdominal mass. Twenty-three of them had no obvious symptoms. There were 6 cases of functional tumors characterized by endocrine disorders and 4 cases of hypoglycemia. Of the 71 patients, 65 received surgery and the other 6 received conservative treatment. The follow-up time ranged from 1 to 184 months. The median follow-up time was 41 months. Forty-five patients survived, of whom 40 had no tumor recurrence, 5 had distant metastasis, 16 died and 7 lost follow-up. Univariate analysis showed that there was no nerve invasion (2 = 8.433), tumor grade (2 = 7.685), tumor stage (2 = 15.204), lymph node metastasis 2 = 14.531) and distant metastasis (2 = 1.060) were associated with prognosis. Multivariate analysis showed that the presence or absence of nerve invasion is an independent factor affecting the prognosis of pancreatic neuroendocrine tumors. Conclusions The surgical method, tumor grade, tumor stage, lymph node metastasis, nerve invasion and distant metastasis may affect the prognosis of pancreatic neuroendocrine tumors. The presence of neurological invasion suggests a poor prognosis.