Analysis Of Diagnosis And Treatment Of 71 Cases Of Pancreatic Neuroendocrine Neoplasms

Objective:To investigate the diagnosis, treatment, prognosis and related factors of pancreatic neuroendocrine neoplasms (pNENs).Methods:Medical records, imaging and pathological examination results were collected from 71 pNENs patients in the Cancer Hospital Chinese Academy of Medical Science & Peking Union Medical College from January 1999 to July 2014. Follow-up examination, retrospective and statistical analysis were performed. The survival rates were calculated by Kpalan-Meier method, and the survival curves were drawn. The survival rates were compared by Log-rank test. The single factor and multiple factor analysis were analyzed through the clinical pathological factors, and the difference was statistically significant with p<0.05.Results:In 71 cases there were 65 patients with non-functional tumors showing clinical symptoms of abdominal pain, bloating and abdominal mass. Whereas 23 patients had no obvious symptoms. There were 6 patients with functional tumors showing symptoms of endocrine disorders. For example,4 of them showed symptoms of hypoglycemia.65 of the 71 patients received surgery treatment, and 6 cases of conservative therapy. In the postoperative follow-up, the follow-up time ranges from 1 to 184 months, with 41 months as the median.45 patients were found alive; 40 patients with no recurrence after regular check-up; 5 patients with distant metastasis,16 patients with death, However,7 patients were lost in the follow-up. Univariate analysis showed resection status(p=0.015), tumor classification(p=0.002), TNM staging(p<0.01), lymph node metastasis status (p=0.004), presence of neural invasion(p<0.01) and distant metastasis(p=0.030) were prognostic factors of pNENs. Multivariate analysis showed that neural invasion was associated with poor short-term outcome as an independent factor.Conclusion:Pancreatic neuroendocrine tumor is a kind of tumor with slow growth and low malignancy, and the prognosis is related to many factors,All of resection status, tumor classification, TNM staging, lymph node metastasis status, presence of neural invasion and distant metastasis had an effect on the prognosis of pNENs, and neural invasion predicted bad prognosis.