Retrospect And Analysis Of Diagnosis,Treatment And Prognosis Of Pancreatic Neuroendocrine Tumors In Changhai Hospital

In order to investigate the diagnosis and treatment experiences of pancreatic neuroendocrine tumors（pNETs）,make more rational diagnosis and treatment projects and improve the life quality and survival rates of patients,clinical datas of 103 cases with pancreatic neuroendocrine tumors were collected from January 2006 to December 2015 in Changhai Hospital affiliated to Second Military Medical University,and all patients received surgical treatments.All paitent’s datas were summarized and analysed from aspects of clinical manifestations,auxiliary examinations,postoperative pathological examination and correlative factors affecting prognosis.Moreover,univariate survival analysis was performed by Kaplan-Meier method,and COX proportional hazards model was used for multivariate survival analysis.The results indicated that 21 patients who showed peculiar symptoms of Whipple triad,Zollinger Ellison syndrome and high blood sugar had functional tumors,while other 82 patients who mainly showed abdominal pain,abdominal distension,backache,abdominal mass and other symptoms had non-functional tumors.The detection rates of B ultrasound,CT and MRI were 60.2 %,84.6 % and 91.3 %,respectively.There were 44 cases located in pancreatic head,18 cases in pancreatic neck and 41 cases in pancreatic body and tail,and the G1 grade was the most frequent grade of pNETs.In addition,the Ki67 index of less than or equal to 5 %,6 %²0 % and greater than 20 % were accounted for 61 cases,17 cases and 25 cases,respectively,and the positive rates of CgA,Syn,NSE,CAM5.2 were 97.1 %,97.1 %,91.3 % and 93.2 % respectively.A total of 92 patients were followed up for 1¹08 months in our research,and the overall survival rate of 5 years was 74.8%.Results of statistical analysis showed that tumor grade（χ₂=26.077）,Ki67 index（χ₂=25.427）,European Association of neuroendocrine tumor stage（χ₂=5.915）,American Cancer Society stage（χ₂=8.411）,lymph node metastasis（χ₂=4.770）and distant metastasis（χ₂=8.411）were associated with the prognosis of pNETs（P< 0.05）,and the tumor grade was an independent risk factors of the pNETs’ overall prognostic factors（HR=3.085,P<0.01）.In addition,the 5 year survival rate between the two groups of Ki67 index less than or equal to 5% and 6%²0% had no statistically significant difference（P=0.760）,and the 5 year survival rate between G1 and G2 groups of tumor pathological classification had also no significant difference（P=0.255）.In conclusion,the pNETs can be located in any part of the pancreas,and the combination of laboratory and various imaging examinations can help make early diagnosis.In addition,the routine pathological examinations and immunohistochemical indexes have important value in the diagnosis and differential diagnosis to this disease.The tumor grade,Ki67 index,ENETS stage,AJCC stage,lymph node metastasis and distant metastasis were closely related to the prognosis of pNETs,and the higher the tumor grade,the worse the prognosis.