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首页> 外文期刊>Medicine. >Survivals of patients with pancreatic neuroendocrine carcinomas: An in-depth analysis by the American Joint Committee on Cancer 8th tumor-node-metastasis staging manual
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Survivals of patients with pancreatic neuroendocrine carcinomas: An in-depth analysis by the American Joint Committee on Cancer 8th tumor-node-metastasis staging manual

机译：胰腺神经内分泌癌患者的幸存者：美国癌症联合委员会第8次肿瘤节点转移分期手册的深入分析

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Recently, the American Joint Committee on Cancer ( AJCC ) 8th staging manual stipulated the World Health Organization (WHO) G3 pancreatic neuroendocrine carcinomas (p-NECs) should all be classified by the system for pancreatic exocrine adenocarcinomas, which had ignored the heterogeneity of G3 p-NECs. We focused on demonstrating whether the heterogeneous subgroups of G3 p-NECs would influence the accurate application of AJCC 8th staging systems. G3 p-NECs were divided into well-differentiated and poorly-differentiated subgroups, whose clinical features and overall survival (OS) were compared. Survival analysis by applying 2 new AJCC 8th staging systems to well-differentiated G3 p-NECs were performed to validate whether these subgroup patients should also be staged by the system proposed for all G3 p-NECs. We enrolled 172 patients who were histopathologically diagnosed as G3 p-NECs, including 64 well-differentiated G3 p-NECs and 108 poorly-differentiated ones, whose patient demographics and tumor characteristics present no notably differences ( P .05), except their Ki-67 index and mitotic rate ( P = .031, P = .025; respectively). The estimated OS of well-differentiated G3 p-NECs was significantly better than those of poorly-differentiated tumors ( P .001). When applying the new AJCC system for all G3 p-NECs to well-differentiated G3 tumors, 18, 22, 12, and 12 patients were respectively distributed in the new AJCC Stage I, Stage II, Stage III, and Stage IV. Using the AJCC 8th staging system for WHO G1/G2 pancreatic neuroendocrine tumors (p-NETs) to well-differentiated G3 p-NECs, there were 5, 25, 22, and 12 patients classified from the new AJCC Stage I to Stage IV, respectively. The system for G1/G2 p-NETs could significantly differentiate the survival differences between each new stage of well-differentiated G3 p-NECs ( P .05), while comparisons of survivals between Stage II with Stage III or Stage III with Stage IV by the system for G3 p-NECs were not statistically different ( P = .334, P = .073; respectively). G3 p-NECs were heterogeneous with well-differentiated and poorly-differentiated subgroups. Both AJCC 8th staging systems proposed for all G3 p-NECs and G1/G2 p-NETs were practical for well-differentiated G3 p-NECs, while the one originally applied to G1/G2 p-NETs appeared to be superior in performance due to its better prognostic stratification and more accurate predicting ability.
机译：最近，美国癌症联合委员会（AJCC）第8次分期手册规定了世界卫生组织（世卫组织）G3胰腺神经内分泌癌（P-NECS）全部应由该系统归类为胰腺外腺癌系统，这忽略了G3的异质性p-necs。我们专注于证明G3 P-NECS的异构亚组会影响AJCC第8次分期系统的准确应用。将G3 P-NEC分为分化良好，分化差的亚组，其临床特征和总体存活率（OS）进行了比较。通过将2个新的AJCC第8次分期系统应用于良好分化的G3 P-NEC来进行存活分析，以验证这些亚组患者是否应由所有G3 P-NEC的系统分组。我们注册了172名组织病理学上诊断为G3 P-NEC的患者，其中包括64种良好分化的G3 p-NECs和108个差异化的患者，其患者人口统计和肿瘤特征没有显着差异（p> .05），除了他们的ki -67指数和有丝分裂率（p = .031，p = .025;分别为;估计的G3 p-necs的估计OS明显优于分化差的肿瘤（p <.001）。在将新的AJCC系统应用于所有G3 P-NEC，以良好分化的G3肿瘤，18,22,12和12名患者分别分布在新的AJCC阶段I，第II阶段，III阶段和第四阶段。使用AJCC第8位G1 / G2胰腺神经内分泌肿瘤（P-NET）至良好分化的G3 P-NEC的分期系统，5,25,22和12名患者从新的AJCC阶段I分为IV阶段，分别。 G1 / G2 P-Net的系统可以显着区分每个新阶段的良好分化的G3 P-NECs（P <.05）之间的存活差异，而阶段II之间的营养人员与第II期与第IV阶段的阶段III之间的比较由G3 P-NEC的系统没有统计学上不同（p = .334，p = .073;分别为; G3 P-NECs是具有良好分化和差异差的亚组的异质性。为所有G3 P-NECS和G1 / G2 P-Net提出的AJCC第8次分期系统都是对良好分化的G3 P-NEC的实用性，而最初应用于G1 / G2 P-Net的术语似乎是优异的性能它更好的预后分层和更准确的预测能力。

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