| Backgrounds:Pancreatic neuroendocrine tumors (PNETs) originated in the systemic diffuse neuroendocrine system, is a rare pancratic tumor. The prognosis and long-term survival in patients with PNETs are superior to those with exocrine pancreatic cancer. In recent years, with the popularization of various imaging diagnostic techniques and the progress of endoscopic diagnosis, the detection rate of PNETs increased, but on the whole, as the etiology and pathogenesis of this disease is not completely clear, its incidence rate is low, the unity of different clinical manifestation and naming and staging, clinical doctors limited awareness of suchtumors, which leads to misdiagnosis and mistreatment in different degree. This retrospective analysis collected 34 patients with PNETs who accepted surgical treatment from January,2006 to June,2014 in Shangdong Provincal Hospital.Then summarize the clinical characteristics and surgical treatment experience of PNETs, to improve the diagnosis and treatment of PNETs before operation.Objective:TO sum up the clinical characteristics and surgical treatment experience and improve the preoperative diagnosis and treatment level of PNETs.Methods:In this study,we conducted a retrospective analysis of clinical data of 34 patients with pancreatic neuroendocrine tumors who accepted surgical treatment from January,2006 to June,2014 in Shangdong Provincal Hospital. Analyse the patient age, sex, clinical manifestations, laboratory indexes and indexes related to pathological differences with the use of statistical software.Results:This study collected a total of 34 patients with PNETs,18 cases of them are female patients,16 cases are male patients, average age was (47.76±12.62), the median age are 48.5 years old (20-74). Functional PNETs has 18 cases, and all of them are insulinomas, the main manifestion are obvious symptoms caused by hypoglycemia, such as paroxysmal dizziness, flustered, heart rate increased, disturbance break out of consciousness, repeatedly hunger, limb tic, kubla khah dripping wet or even coma. No functional PNETs has 16 cases, main manifestion are the digestive tract symptoms:6 cases have abdominal pain, abdominal distension;2 cases diarrhea; 1 case has nausea and vomiting.2 cases has jaundice, including 1 case with fever.1 case is thiner and suffer weight loss. No physical discomfort or positive symptoms but only for general medical examination or accidental medical discoverer have 4 cases. Ultrasound positive found 24 cases, CT positive found 24 cases, positive MRI findings have 10 cases and 7 cases have PET-CT positive findings.34 patients were accepted surgical treatment,17 of them accepted resection of pancreatic body tail (with or without spleen), Whipple surgery 7 cases, pancreatic segmental resection 2 cases, tumor resection 3 cases, tumor removed 4 cases.In addition,4 cases of PNETSs patients with liver metastases,1 got routine chemotherapy with radiofrequency therapy,1 underwent radiofrequency therapy,1 accepted routine chemotherapy with TACE treatment,1 case underwent chemotherapy after surgical removal of the mass. Postoperative pathological of the tumors show that the tumor diameter range from lcm to 8 cm, with an average diameter of 2.86 cm and 3 cases are bigger than 5 cm. Follow-up results show that 32 cases are still alive and 2 cases have died.Conclusions:PNETs is a kind of rare low-grade malignant heterogeneitic tumor with a variety of clinical manifestations, the preoperative misdiagnosis rate is high, its diagnosis depends on pathological. The new TNM staging and pathological classification can actively guide the prognosis evaluation. Patients with a positive operation or the operation based comprehensive treatment can obtain good prognosis. |
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