Prognostic factors in patients with Zollinger-Ellison syndrome and multiple endocrine neoplasia type 1
Prognostic factors in patients with Zollinger-Ellison syndrome and multiple endocrine neoplasia type 1
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DOI：
10.1016/s0016-5085(99)70124-1
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发表时间：
1999-02-01
期刊：
影响因子：
29.4
通讯作者：
Mignon, M
中科院分区：
文献类型：
--
作者：
Cadiot, G;Vuagnat, A;Mignon, M
背景和目标：Zollinger-Ellison综合征和多发性内分泌瘤1型患者异时性肝转移和死亡的危险因素尚不清楚。在77例患者中回顾性确定了这些因素。方法：进行数据图表审查。结果：中位随访时间为102个月（范围：12-366）。对48例患者进行了手术，包括10例大胰腺肿瘤（大于或等于3 cm）患者中的9例。4例（40%）大胰腺肿瘤患者发生肝转移，3例（4.8%）无肝转移，4例胰腺肿瘤（大小未知）患者中有1例发生肝转移;所有患者既往均接受过手术。通过多变量分析确定的与河流转移发展相关的唯一独立因素是大胰腺肿瘤（风险比，29.0; 95%置信区间[CI]，3.2-260.7）。未选择手术。63名无大胰腺肿瘤的患者在10年和15年时无肝转移的概率为96%（95%CI，88-100）。13例（16.9%）患者死亡。多变量分析选择的唯一独立死亡因素是1980年以前诊断为Zollinger-Ellison综合征（风险比，8.2; 95%CI，1.7-40.6）和诊断时的年龄（风险比/年，1.08; 95%CI，1.03-1.14）。结论：大胰腺肿瘤预示着异时性肝转移的发生，手术似乎不能预防。
Background & Aims: Risk factors of metachronous river metastases and death are not well known in patients with the Zollinger-Ellison syndrome and multiple endocrine neoplasia type 1. These factors were retrospectively determined in 77 patients. Methods: Data chart review was performed. Results: Median follow-up was 102 months (range, 12-366). Surgery was performed on 48 patients, including 9 of the 10 patients with large pancreatic tumors (greater than or equal to 3 cm). Liver metastases developed in 4 patients (40%) with large pancreatic tumors, in 3 (4.8%) without, and in 1 of the 4 patients with pancreatic tumors of unknown size; all had previously undergone surgery. The only independent factor associated with development of river metastases identified by multivariate analysis was large pancreatic tumors (risk ratio, 29.0; 95% confidence interval [CI], 3.2-260.7). Surgery was not selected. The probability of being free of liver metastases in the 63 patients without large pancreatic tumors was 96% (95% CI, 88-100) at 10 and 15 years. Thirteen (16.9%) patients died. The only independent factors of death selected by multivariate analysis were Zollinger-Ellison syndrome diagnosis before 1980 (risk ratio, 8.2; 95% CI, 1.7-40.6) and age at diagnosis (risk ratio/year, 1.08; 95% CI, 1.03-1.14). Conclusions: Large pancreatic tumors are predictive of the development of metachronous liver metastases, and surgery does not seem to prevent them.