| Objective:To conclude the clinical data of patients with Pancreatic neuroendocrine tumors(PNETs)and relevant literature both foreign and domestic;To analysis and investigate the disease onset pattern,clinical symptoms,pathological features,treatment and prognosis;To enhance the clinicians’ understanding of this kind of disease;and to promote the development of medical techniques for diagnosing PNETs.Materials and method:A total of 36 subjects with PNETs from first affiliated hospital and second affiliated hospital of Dalian Medical university(2006-01 to 2016-06)were recruited in this regression analysis.Clinical data and pathological information were analyzed by statistical software,and regression study was conducted in disease onset pattern,clinical symptom,laboratory examination,pathological feature,diagnosing method and prognosis.Result:1.A total of 36 subjects with PNETs was recruited in this research,with 23 female cases and 13 male cases;male female ratio was approximately 1:1.77;age distribution 15-73;average age 46.1 ± 16;median age 47.5;2.4 cases of NF-PNETs(66.7%)excluding 13 accidental discovered shared the symptoms of abdominal pain,nausea,inappetence and jaundice;12 cases of F-PNETs(33.3%)were composed of 11 insulinoma cases and VIP tumor;the symptoms in 11 insulinoma cases were related to hypoglycemia,such as palpitation,increased heart rate,dizziness,lethargy,consciousness disturbance,hunger,limbs convulsion and abnormal behavior;1 VIP tumor case was observed notable marasmus,hypokalemia and severe diarrhea.3.B-mode ultrasound was applied to 26 subjects with a positive incidence of 65.4%;CT scanning of the upper abdomen was utilized in 29 subjects with a positive incidence of 96.6%;MRI of the upper abdomen was implemented in 25 subjects with a 100%positive incidence.ALL pancreatic neoplasms were noticed in 3 subjects who received PETCT.36 PNET cases were at the pancreatic head,and 24 PNET cases were at pancreatic body or tail.4.35 subjects received surgical therapy,with 31 cases of conventional laparotomy and 4 cases of endoscope(conversion to laparotomy 1 case);17 cases(45.7%)of neoplasm resection,5 cases(14.3%)of pancreatoduodenectomy,4 cases(11.4%)of pancreatic tail resection,7 cases(20%)of pancreatic tail and spleen resection,3 cases(8.6%)of middle pancreatectomy and pancreaticojejunostomy.In addition,1 subject was diagnosed as pancreatic neuroendocrine tumor with hepatic metastasis by aspiration biopsy,and left hospital for surgery refusal.Main postoperative complication was pancreatic fistula(48.6%).5.The tumors extracted had a diameter 0.8-7.0cm,average 3.2±1.8cm,median size 2.5cm;average diameter of F-PNETs was 1.7±0.6cm and 1.7±0.6cm for NF-PNETs.Based on WHO grading system,13 subjects(39.4%),19 subjects(57.6%)and I subject(3.0%)were categorized in to G1,G2 and G3 respectively.The positive incidence of CgA in 32 cases was 84.4%,and 90.9%for syn staining.2 hepatic metastasis cases were discovered before surgery,and 5 cases were certified lymph node metastasis after operation.6.35 out of 36 subjects received follow-up visits,except 2 death cases,all other subjects were alive and no tumor relapse and metastasis observed.Conclusion:PNETs are an uncommon type of pancreatic tumor with low potential malignancy.Functional PNETs is often accompanied with specific clinical symptoms.Most non-functional PNETs have no obvious symptoms while non-specific clinical symptoms are seen in exceptional cases.The diameter of functional PNETs tumor is generally smaller than that of non-functional PNETs;F-PNETs usually occur in the elderly patient.Radiology is a crucial approach in tumor location,lymph node condition evaluation and the possibility of metastasis.Lower positive incidence is in B-mode ultrasound,but CT and MRI have higher diagnostic rate.Surgical therapy is the main method in PNETs treatment,and the surgical method is determined by tumor location,diameter,and metastasis status.Pancreatic fistula is the major postoperative complication.Syn and CgA are the immunohistochemical indicators with high specificity and sensibility in practice.According to PNETs pathological classification.G1 and G2 are usually seen with favorable prognosis;G3 is rarely seen with a worse prognosis. |
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