Clinicopathological features and long-term prognosis of purely cystic pancreatic neuroendocrine tumors: A single center experience.
Clinicopathological features and long-term prognosis of purely cystic pancreatic neuroendocrine tumors: A single center experience.
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DOI：
10.1016/j.asjsur.2022.07.029
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发表时间：
2022-07
影响因子：
3.5
通讯作者：
S. Ren;Xing Wang;N. Ke;Qingquan Tan;F. Yang;Wen-qing Yao;Chunlu Tan;Xu-Bao Liu
中科院分区：
文献类型：
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作者：
S. Ren;Xing Wang;N. Ke;Qingquan Tan;F. Yang;Wen-qing Yao;Chunlu Tan;Xu-Bao Liu
背景胰腺神经内分泌肿瘤（pNETs）是一种异质性肿瘤，其预后差异很大。胰腺囊性神经内分泌肿瘤（C-pNETs）是pNETs的一小部分，其数据非常罕见。本研究旨在比较C-pNETs和固体pNETs（S-pNETs）之间的临床病理和长期生存差异。方法回顾性分析了2009年至2019年在我们机构接受切除术的242例pNETs患者。人口统计学特征，临床病理特征和长期outcomes.Results16 242例（6.6%）被确定为C-pNETs。与S-pNETs相比，C-pNETs更常无功能（75% vs 45%，P = 0.02），C-pNETs的中位肿瘤直径更小（36 mm vs 47 mm，P = 0.001）。术前诊断C-pNETs的准确率明显低于术前（31%vs78%，P = 0.001）。值得注意的是，大多数C-pNET与G1分化良好（81% vs 35%，P = 0.001）。C-pNETs中无G3（0vs7%，P = 0.001）。C-pNET中未检测到T4期或R1/R2手术切缘。仅1例（6%）有局部淋巴结转移（N）或同时远处转移（M）。此外，只有一名C-pNET患者（6%）出现肿瘤复发，而S-pNET患者有24名（13%）。结论C-pNETs是一种少见的亚型，与实体瘤相比，C-pNETs的侵袭行为可能较轻。复发和肿瘤相关死亡仍然发生在切除C-pNETs的患者中，尽管他们往往具有更有利的预后。
BackgroundPancreatic neuroendocrine tumors (pNETs) are heterogenous neoplasms, of which the prognosis varies widely. Purely cystic pancreatic neuroendocrine tumors (C-pNETs) are a small subset of pNETs in which data are extremely rare. This study aimed to compare clinicopathological and long-term survival differences between C-pNETs and solid pNETs (S-pNETs).MethodsA retrospective review of 242 patients with pNETs underwent resection in our institution from 2009 to 2019 was conducted. Demography characteristics, clinicopathological features and long-term outcomes of them were analyzed.ResultsSixteen out of 242 patients (6.6%) were identified as C-pNETs. Compared with S-pNETs, C-pNETs were more frequently non-functional (75% vs 45%, P = 0.02), and the median tumor diameter of C-pNETs was smaller (36 mm vs. 47 mm, P = 0.001). And the accuracy of preoperative diagnosis of C-pNETs was significantly lower (31% vs 78%, P = 0.001). Of note, the majority of C-pNETs were well-differentiated with G1 (81% vs 35%, P = 0.001). And there were no G3 (0 vs 7%, P = 0.001) in C-pNETs. No T4 stage or R1/R2 surgical margin detected in C-pNETs. And only one C-pNETs (6%) had regional lymph node metastasis (N) or synchronous distant metastasis (M). Additionally, only one patient with C-pNETs (6%) suffered tumor recurrence, compared with 24 (13%) for S-pNETs. And survival analysis showed the patients with C-pNETs seemed to be with better disease-free survival (P = 0.26).ConclusionC-pNETs are rare subtype with possibly less aggressive behavior comparing with their solid counterparts. Recurrence and tumor-related death still occurs in patients with resected C-pNETs, although they tend to be with more favorable prognosis.