Analysis Of Clinical Diagnosis,Treatment And Efficacy Of Pancreatic Neuroendocrine Tumors

Objective To explore the high risk factors of recurrence and progression of pancreatic neuroendocrine tumor under the new pathological grade.Methods A total of 66 patients with pancreatic neuroendocrine tumors confirmed by pathology in Ningxia Medical University hepatobiliary surgery,oncology department and general surgery department from December 2012 to December 2020 were analyzed retrospectively.Stata23.0 software was used for statistical analysis.The median progression-free survival time refers to the corresponding survival time when the progression-free survival rate is 50%.The average value is expressed by（X±S）.The Kaplan-Meier method is used to draw the progression-free survival curve,and the Log-rank test is used to compare the differences in survival processes among different groups,Cox regression was used for multivariate survival analysis.The sample rates of different groups were compared by c₂ test.The difference was statistically significant（P < 0.05）.Results There were 28 cases（42%）in G1 group,23 cases（35%）in G2 group,7 cases（11%）in G3 group and 8 cases（12%）in NEC group.The follow-up time was 1 to 89 months,and the average progression-free survival time was（35.45 ±3.08）months.The average progression-free survival time was（40.43 ±4.65）months in G1 group,（40.18 ±5.2）months in G2 group,（24.28 ±8.38）months in G3 group and（11.85 ±3.65）months in NEC group.Univariate analysis showed that pathological grade（c₂= 20.18,P < 0.000）,lymph node metastasis（c₂= 10.75,P < 0.000）,nerve invasion（c₂= 19.70,P < 0.000）,vascular tumor thrombus（c₂= 24.43,P < 0.000）,TNM stage（c₂= 10.98,P < 0.012）were risk factors for tumor progression and recurrence,Multivariate analysis showed that high grade（G3 +NEC）was an independent risk factor for tumor recurrence or progression（P=0.042HR=7.83 95%CI:1.073～57.14）Conclusion pNET is a highly heterogeneous tumor with good overall prognosis and various clinical manifestations.The principle of treatment is surgery-based comprehensive treatment.Pathological grade,TNM stage,lymph node metastasis,vascular tumor thrombus and nerve invasion are the factors affecting tumor progression or recurrence.Pathological grade is an independent risk factor for tumor recurrence or progression in these factors.However,the single-center study has some limitations,and multicenter prospective clinical studies need to be carried out in the future.