摘要：
目的 分析胰腺神经内分泌肿瘤(pNETs)的临床特点、诊断、治疗及预后相关因素.方法 选取经病理检查确诊的胰腺内分泌肿瘤患者54例,收集相关临床资料,包括年龄、性别、临床表现、检查检验、手术方案、预后等,并对其进行回顾性分析,通过单因素分析法求证各因素与预后之间的关系.结果 本研究患者总生存时间(OS)为1 ～ 87个月,中位生存时间(MOS)为30个月.死亡4例,1例死于术后胰漏,余3例均死于肿瘤复发、转移.3年及5年生存率分别为86％和78％.54例pNETs患者中,功能性占55.6％ (30/54),无功能性占44.4％(24/54).单因素分析结果显示淋巴结转移、肝转移、TNM分期、病理分级以及是否行根治性手术与预后相关(P＜0.05).结论 pNETs是一类低度恶性的罕见肿瘤,初步诊断可依据特殊的临床表现、特异性的生化指标和敏感度较高的影像学检查,确诊仍需病理证实.手术切除是治疗胰腺内分泌肿瘤的有效方法.TNM分期和世界卫生组织(WHO)病理分级有助于评估预后,且淋巴结转移、肝转移对预后有影响.%Objective To investigate and analyze the clinical characteristics,diagnosis,treatment,and prognostic factor of neuroendocrine tumors of the pancreatic (pNETs).Methods Fifty-four patients of pancreatic endocrine tumor diagnosed by pathological examination were seleced.Related clinical data,including age,sex,clinical manifestation,examination,operation plan,prognosis,were collected.Correlation of these factors with PNETs prognosis was proven by univariate analysis.Results In our study,the overall survival was arranged from 1 to 87 months;the median overall survival was 30 months.Totally,there were 4 cases of death,of which 1 case died of the postoperative pancreatic leakage,and 3 cases died of the tumor recurrence and metastasis.The survival rates in three years and five years were 86％ and 78％ respectively.Among the 54 patients with pNETs,55.6％ (30/54) was functional and 44.4％ (24/54) was not functional.Univariate analysis showed that factors such as lymph node metastasis,liver metastasis,TNM staging,and pathological grading and radical operation were associated with prognosis (P ＜ 0.05).Conclusions pNETs are rare low-grade malignant tumors with heterogeneity.The primary diagnosis of pNETs depends on special clinical syndromes,specific biochemical indexes,and the high sensitivity of imaging examinations,while the final diagnosis still needs evidence of pathology.Surgery is the only potentially curative approach for pNETs.TNM staging and the WHO pathological classification can actively guide the prognosis evaluation.The lymph node metastasis and liver metastasis affected the prognosis of PNETs.
