【摘要】：目的回顧性的分析高分化胰腺神經(jīng)內(nèi)分泌腫瘤(pNENs)術(shù)后患者的臨床病理資料,探討影響pNENs術(shù)后復(fù)發(fā)的相關(guān)危險(xiǎn)因素及中藥預(yù)防高分化pNENs術(shù)后復(fù)發(fā)的作用。方法回顧性的分析了 2012年1月至2016年12月中日友好醫(yī)院47例高分化pNENs術(shù)后患者的臨床病理資料,分析高分化pNENs術(shù)后復(fù)發(fā)的危險(xiǎn)因素。根據(jù)患者術(shù)后是否接受中藥輔助治療,分為中藥組和對照組,比較兩者復(fù)發(fā)率和無病生存期(DFS)有無差異,并行pNETs患者術(shù)后復(fù)發(fā)危險(xiǎn)因素的單因素及多因素分析。結(jié)果全組收集47例pNENs術(shù)后患者,其中38例(80.9%)為無功能pNETs,9例(19.1%)為功能性pNETs。腫瘤位于胰頭共16例(34.0%),胰體尾15例(31.9%),胰尾9例(19.1%),胰體3例(6.4%)。腫瘤大小在0.3cm至13cm之間(4.02±2.51)。病理分級(jí)中,G1級(jí)共13 例(27.7%),G2 級(jí)共 32 例(68.1%)。臨床分期中 T1:9 例(19.1%),T2:20例(42.6%),T3:13(27.7%)。N0:28 例(59.6%),N1:16 例(34%)。IA 期共 9 例(19.1%),IB期13期(27.7%),ⅡA期6例(12.8%),IHB期14例(29.8%)。全組病人共有22例(46.8%)患者接受中藥治療,共有20例(42.6%)患者未接受任何術(shù)后輔助治療,有5例(10.6%)患者接受其他治療,全組患者中共有17例(36.2%)患者出現(xiàn)術(shù)后復(fù)發(fā)。中藥組共22例,其中有5例復(fù)發(fā),1年復(fù)發(fā)率為5.9%,2年復(fù)發(fā)率為25.1%,3年復(fù)發(fā)率為25.1%,估計(jì)中位DFS為72個(gè)月(95CI 6.3,137.7月)。對照組共20例,共有8復(fù)發(fā),1年復(fù)發(fā)率20%,2年復(fù)發(fā)率52.6%,3年復(fù)發(fā)率為68.4%,估計(jì)中位DFS為23個(gè)月(95CI 11.1,34.9月)。單因素分析表明Ki67指數(shù),臨床分期,中藥輔助治療,淋巴結(jié)轉(zhuǎn)移,腫瘤是否超出胰腺,切緣性質(zhì)與pNETs患者術(shù)后復(fù)發(fā)相關(guān)(P0.05),多因素分析結(jié)果表明淋巴結(jié)陽性、Ki67陽性指數(shù)"g10%是pNETs患者術(shù)后復(fù)發(fā)的獨(dú)立危險(xiǎn)因素(p0.05),中藥術(shù)后輔助治療是預(yù)防pNETs患者術(shù)后復(fù)發(fā)的保護(hù)性因素。結(jié)論淋巴結(jié)轉(zhuǎn)移、Ki67陽性指數(shù)會(huì)10%是pNETs患者術(shù)后復(fù)發(fā)的獨(dú)立危險(xiǎn)因素,而中藥術(shù)后輔助治療是預(yù)防pNETs患者術(shù)后復(fù)發(fā)的保護(hù)性因素,中藥在降低pNENs術(shù)后復(fù)發(fā)率、延長DFS有統(tǒng)計(jì)學(xué)意義。
[Abstract]:Objective to retrospectively analyze the clinicopathological data of well-differentiated pancreatic neuroendocrine tumors after (pNENs), and to explore the risk factors affecting the recurrence of pNENs and the role of Chinese medicine in preventing the recurrence of well-differentiated pNENs. Methods the clinicopathological data of 47 patients after well-differentiated pNENs in China-Japan Friendship Hospital from January 2012 to December 2016 were analyzed retrospectively and the risk factors for recurrence of well-differentiated pNENs were analyzed. Patients were divided into Chinese medicine group and control group according to whether they received Chinese medicine adjuvant therapy after operation. The recurrence rate and disease-free survival (DFS) were compared between the two groups. The single factor and multivariate analysis of the risk factors of recurrence in patients with pNETs were also analyzed. Results 47 cases of postoperative pNENs were collected, of which 38 cases (80.9%) were nonfunctional pNETs,9 cases (19.1%) were functional pNETs.. The tumors were located in the head of pancreas in 16 cases (34.0%), the body and tail of pancreas in 15 cases (31.9%), the tail of pancreas in 9 cases (19.1%) and the body of pancreas in 3 cases (6.4%). The tumor size ranged from 0.3cm to 13cm (4.02 鹵2.51). 13 cases (27.7%) were in G1 grade and 32 cases (68.1%) in G2 grade. There were 9 cases (19.1%) of T 1:, 20 cases (42.6%) of T 2:, 13 cases of T 3: 13 (27.7%), 28 cases of N 0: 28 (59.6%), 16 cases of N 1: 16 (34% of). IA), 9 cases (19.1%). IB stage 13 (27.7%), stage 鈪，

本文編號(hào)：2406191