Diagnosis And Treatment Of Neuroendocrine Tumors Of Pancreas And Its Prognosis

Objective To investigate the clinical features,imaging characteristics, pathologicalfeatures,diagnosis and treatment,prognosis of Pancreatic neuroendocrineneoplasms (PNENs).Method211patients were retrospectively reviewed and analyzed to summarizethe characteristics of clinics, image,diagnosis, treatment and their prognosis.Results Among211patients,132cases were functional insulinomas(43males and89females）, with a average age of42.8±14.5years (age range15-77years)；79cases were non functional Pancreatic neuroendocrine neoplasms(35males and44females),with a average age of48.2±13.0years (age range16-80years). Mostinsulinomas presented with symptoms of hypoglycemia while nPNENs presentedwith nonspecific symptoms. In combination with clinical presentations,imageexamination help determine the location of tumor and make the correct diagnosis,but the nature of the tumor remains to be confirmed pathologically. All211patients received surgery treatment,195(92.4%) patients were treated with radicaltumor resection procedure. The most common complication was pancreatic fistula,with the incidence of30.3%. The results of immunohistochemistry show thatseveral markers(such as Syn、CgA、CD56)s were positive in PNENs.211patientswere followed up, time range7-114months. Statistical analysis showed thattumor feature, surgical procedure and TNM staging affects patients prognosislonely.Conclusions1. Pancreatic neuroendocrine neoplasms (PNENs) is a rarepancreatic tumor. Despite the functional insulinomas, the clinical features ofPNENs are non-specific.2. Preoperative image examination can determine tumorsize,location, relationship with surrounding organ or tisure and differentiationwith other pancreatic tumor, also decide the final surgical strategy.3. Surgery is the primary treatment. Most of patients who received radical tumor resection havegood prognosis. Surgery procedure varies depend on tumor functional or not.Laparoscopic surgery was becoming increasingly popular in treating insulinomas.4. PNENs have better prognosis than pancreatic adenoma and close follow-up istherefore necessary. Statistical analysis showed that tumor feature, surgicalprocedure and TNM staging affects patients prognosis lonely.