摘要
目的回顾性分析胰腺神经内分泌肿瘤的临床病例资料，加强对该病的认识和诊治。方法收集南京军区南京总医院1999年1月-2012年12月的37例胰腺神经内分泌肿瘤住院患者的临床症状、影像学检查、病理、手术治疗、随访等资料进行分析。结果本组患者中，33例（89．2％）为非功能性肿瘤，4例（10．8％）为功能性肿瘤。非功能性肿瘤以腹痛、腹胀、腹泻、黄疸为主要表现，8例无任何症状；功能性肿瘤以低血糖反应为主要表现。病灶的检出率B超为80％，CT、MRI以及PET／CT均为100％，病变部位以胰头部最常见，瘤体平均直径为5．7cm（1．4～20cm）。病理学分类以神经内分泌癌最常见，其次为胰岛细胞瘤，免疫组化CgA、Syn、NSE、CKpan的阳性率分别为66．7％、92．9％、87．5％、73．3％。有15例患者发生肿瘤转移，以肝脏（6例）和淋巴结（5例）转移常见。27例患者行手术治疗，手术相关并发症发生率为29．6％（8／27），无手术相关的死亡病例。术后随访病例34例，其中8例复发，3例死亡。结论胰腺神经内分泌肿瘤的临床症状无明显特异性，影像学检查有助于早期诊断肿瘤、发现转移灶及术前评估，手术治疗有助于延长患者生存期，术后密切随访有利于早期发现和处理复发病灶。
Objective To analyze the clinical data of pancreatic neuroendocrine tumors （PNETs）, for furthe： knowledge, diagnosis and treatment of the disease. Methods The clinical symptoms, imaging studies, pathology, sur gery and follow-up data which were collected from 37 PNETs patients in the Nanjing General Hospital of Nanjing Militar] Command of PLA from Jan. 1999 to Dec. 2012 were analyzed. Results Thirty-three cases （89.2%） were non-func tional tumors and 4 cases （10.8%） were functional tumors in the study. The common clinical symptoms of non-fune tional tumors were abdominal pain, bloating, diarrhea and jaundice and 8 cases had no symptoms ; most of the functiona tumors performed with hypoglycemia. The positive rates of type-B ultrasonic for detection tumor were 80% , CT, MR and PET/CT were 100%. The head of the pancreas was the most frequent site of PNETs and the average diameter o tumor was 5.7 cm （1.4 - 20 cm）. According to pathological classification, the most common PNETs was neuroendo crine carcinoma, followed by islet cell tumor. The immunohistoehemical positive rates of CgA, Syn, NSE, and CKpal were 66.7% , 92.9% , 87.5% and 73.3% accordingly. Tumor metastasis happened on 15 patients, the common site~ were liver （n =6） and lymph nodes （n =5）. Twenty-seven patients had underwent surgery, 29.6% （8/27） of then had the procedure-related complications, no procedure-related deaths. During the postoperative follow-up of 34 cases there were 8 cases of recurrence and 3 deaths. Conclusion PNETs have no specific clinical symptoms. Medical imag ings contribute to the early diagnosis, detection of metastases and preoperative evaluation of this disease. The surger helps to prolong survival time of PNETs patients, close follow-up of postoperative patients is conducive to early detectio and treatment of recurrent lesions.
出处
《胃肠病学和肝病学杂志》
CAS
2014年第4期456-459,共4页
Chinese Journal of Gastroenterology and Hepatology
关键词
胰腺
神经内分泌肿瘤
回顾性分析
Pancreas
Neuroendocrine tumors
Retrospective analysis
