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目的探讨胰腺神经内分泌肿瘤(PNETs)的外科治疗决策。方法收集广东省人民医院2000年1月至2010年1月间收治的60例PNETs病人的临床病理学资料,对相关资料进行分析,探讨临床特点、手术方式与预后的关系。结果 60例PNETs中32例(53.3%)为功能性,28例(49%)为无功能性;G1、G2和G3级肿瘤分别占70%、15%、15%;发现淋巴结转移8例,肝转移8例;54例获得R0切除,6例行姑息性手术;单因素分析提示肿瘤大小、分级、淋巴结转移、肝转移是影响PNETs预后的主要因素。结论手术是PNETs的主要治疗手段,肿瘤大小、分级、淋巴结转移、肝转移是PNETs重要预后因素;直径<2 cm的PNETs手术指征需更多的临床研究支持,建议对除胰岛素瘤之外的其他PNETs常规行淋巴结清扫术。
Objective To investigate the surgical treatment of pancreatic neuroendocrine tumors (PNETs). Methods The clinical and pathological data of 60 cases of PNETs patients who were treated in Guangdong Provincial People’s Hospital from January 2000 to January 2010 were collected and the related data were analyzed to explore the relationship between the clinical features, operation methods and prognosis. Results 32 (53.3%) of 60 PNETs were functional and 28 (49%) were nonfunctional. The G1, G2 and G3 tumors accounted for 70%, 15% and 15% respectively. There were 8 cases of lymph node metastasis, Liver metastases in 8 cases; 54 cases of R0 resection, 6 cases of palliative surgery; univariate analysis showed that tumor size, grading, lymph node metastasis, liver metastasis is the main factor affecting the prognosis of PNETs. Conclusions Surgery is the main treatment for PNETs. Tumor size, grading, lymph node metastasis and liver metastasis are important prognostic factors of PNETs. PNETs with diameter less than 2 cm require more clinical research support. It is suggested that in addition to insulinoma Other PNETs routine lymphadenectomy.