Prognostic Analysis Of Clinical Features And Pathological Grades Of Pancreatic Neuroendocrine Neoplasms

Purpose: In this study,age,gender,tumor size,pathological grade,TNM stage,lymph node metastasis,functional status,treatment plan and other indicators were counted,in order to clarify the relationship between between clinical features,pathological grades and prognosis of patients.Methods:This study collected a total of 57 patients diagnosed with pancreatic neuroendocrine neoplasms in the affiliated hospital of Qingdao university from January 2011 to October 2017.Follow-up methods included telephone follow-up,outpatient or inpatient review.SPSS23.0 software package was used for statistical analysis of the data,frequency and composition ratio were used to describe the distribution of classified data,chi-square test was used to compare the differences between classified data groups,kaplan-meier test was used for survival analysis and survival curve was drawn,and logrank test was used for survival rate comparison.Cox regression was analyzed by multiple factors.P < 0.05 was considered statistically significant.Results: Non-functional tumors in pancreatic neuroendocrine neoplasms accounted for 63.1%,and the clinical manifestations were lack of specificity,including upper abdominal discomfort,diarrhea,abdominal pain,and wasting.Functional tumors accounted for 36.9%,with insulinoma being the most common.The detection rate of abdominal CT was 83.6%(46/55),the detection rate of MRI was 100%(30/30),and the detection rate of digestive system was 42.5%(20/47).The survival prognosis of patients with stage I and II in TNM stage was better than that of stage III and IV patients,P<0.01,which was statistically significant.The survival prognosis of patients with G1 and G2 grades in WHO classification was better than that of patients with G3 grade,P<0.01,which was statistically significant,patients with liver metastasis had a worse prognosis than patients without liver metastasis,P=0.035,which was statistically significant,patients with lymph node metastasis had worse survival prognosis than patients without lymph node metastasis,P<0.01,which was statistically significant.Surgical treatment was superior to non-surgical patients in survival outcome,P <0.05,which was statistically significant.Tumor size was associated with pathological grade(P<0.05),but there was no statistically significant difference in prognosis(P=0.350).Multivariate analysis did not show independent factors affecting the prognosis of P-NENs.Conclusion: This study reminds that pancreatic neuroendocrine neoplasms are mainly non-functional tumors.Abdominal CT and MRI are effective examination methods.Patients with clinical features such as lymph node metastasis,liver metastasis,and TNM stage III,IV are with poor prognosis.Patients with pathological grade of G3 are with poor prognosis.Surgical treatment of patients with good prognosis,can be used as an effective means of treatment of pancreatic neuroendocrine neoplasms.