Analysis Of Pathological Feature, Diagnosis And Treatment Of The Pancreatic Neuroendocrine Tumors

Objective:To investigate the Clinicopatholocal features, imaging perfo-rmance and the treatment of pancreatic neuroendocrine neoplasms (P-NETs) and analyze the prognosis of it.Methods:47 patients with pancreatic neuroendocrine tumors cured in the 4th hospital of Hebei Medical University between June 2005 and June 2014 were retrospectively analyzed, and the datum of cases, pathology reports, treatments and prognosis of them were analyzed and summarized.Results:The 47 cases were made up of 16 male patient and 31 female patients with the age ranging from 14 to 82. CT or MRI scans were conducted to all patients. Tumors were located in the head of the pancreas in 19 cases while 3 in the neck of the pancreas and 11 in the body of the pancreas in which Liver metastases was found in 1 case,13 in the tale of the pancreas in which also liver metastases was found in 1 case.1 case had multiple tumors in the pancreas. All patients accepted resection operations except 1 case who went under the TACE. Of all the operation cases,17 accepted the pancr-eatoduodenoectomy,4 accepted the local excision,23 cases accepted the Distal Pancreatectomy,1 case with pancreatic body tumor and liver metastases accepted distal pancreas, spleen, left segmental liver and tumor in right segmental liver excision.1 case who had multiple tumors in the pancreas accepted pancreatic neck, body and tale excision. Liver metastases occurred in 1 case who had accepted operation and then had microwave coagulation. All the samples were made pathology examination and confirmed to be P-NETs including 40 pancreatic neuroendocrine tumors and 7 pancreatic neuroen-docrine carcinomas.10 of the cases were functional tumors with 7 at grade I and 3 at grade 2 of the pathology grading.30 cases were non-functional with 20 cases at grade 1 and 10 cases at grade 2 of the pathology grading.1 case was functional neuroendocrine carcinoma while 6 cases were non-functional neuroendocrine carcinomas. The number of cases classified in clinical stage I, II, III or IV is 37,7,1 and 2 respectively including 36 cases of stage I and 4 cases of stage II pancreatic neuroendocrine tumors. All cases of stage III and IV were pancreatic neuroendocrine carcinomas. The statistical result shows that the grading and stages of tumors are with no significant differences while the functional pancreatic neuroendocrine tumors were compared with the non-functional ones. But while the pancreatic neuroendocrine tumors were compared with pancreatic neuroendocrine carcinomas, the statistical results showed significant differences. IHC showed that the positive rate of CgA was 93.6%, and the positive of CgA in pancreatic neuroendocrine tumors was 95%, while it in pancreatic neuroendocrine carcinomas was 85.7%; the positive rate of Syn was 95.7%, and the positive of Syn in pancreatic neuroendocrine tumors was 97.5%, while it in pancreatic neuroendocrine carcinomas was 85.7%. Statistical results showed that there were no significant differences between the expression of the Syn and CgA in the pancreatic neuroendocrine tumors and the one in the pancreatic neuroendocrine carcinomas. Follow up visit was made to 30 cases for 4 to 108 months, all cases survived including 1 case who accepted microwave coagulation therapy because of the liver metastases and the other 29 cases with no tumor recurrence and metastasis.Conclusion:pancreatic neuroendocrine tumor occurs in all parts of the pancreas, CT and MRI are the most important examinations and pathology makes the definite diagnosis, surgical operation is the main therapy, and targeted therapy, RFA, chemotherapy are also optional treatments. The prognosis of pancreatic neuroendocrine tumor is good.