Clinicopathological characteristics and prognostic factors of patients with primary gallbladder neuroendocrine carcinomas
Clinicopathological characteristics and prognostic factors of patients with primary gallbladder neuroendocrine carcinomas
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DOI：
10.1111/1751-2980.13088
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发表时间：
2022-03-15
影响因子：
3.5
通讯作者：
Wang, Jian
中科院分区：
文献类型：
--
作者：
Wang, Wei;Yang, Chuan Xin;Wang, Jian
目的原发性胆囊神经内分泌癌（GB-NEC）是一种有待进一步研究的恶性肿瘤。本研究旨在总结GB-NEC患者的临床病理特点、有效治疗及预后因素。方法选取2012年10月~ 2020年8月上海交通大学附属第六人民医院和上海交通大学医学院仁济医院收治的GB-NEC患者。我们记录了我们的患者的临床病理特征和以前的研究报告。生存率分析采用Kaplan-Meier法、单因素和多因素Cox回归分析。结果本院患者15例，既往研究患者47例。55名接受手术切除的患者，包括R-0和非R-0切除的患者，与其他7名患者相比，总生存期明显更长。单因素分析表明，年龄在60岁或以上、伴有黄疸、类癌综合征、非r -0切除和晚期的患者与较差的生存率相关。一项多因素分析显示，60岁及以上的患者，类癌综合征和非r -0切除术，但不包括淋巴结切除术和辅助化疗，与生存率降低独立相关。结论R-0切除应作为GB-NEC的一线治疗。老年、类癌综合征和非r -0切除与手术切除后生存率降低独立相关。
Objectives Primary gallbladder neuroendocrine carcinomas (GB-NEC) are malignant neoplasms that remained to be studied. In this study we aimed to summarize their clinicopathological characteristics, effective treatment and prognostic factors for patients with GB-NEC. Methods Patients with GB-NEC admitted to Shanghai Jiao Tong University Affiliated Sixth People's Hospital and Renji Hospital, School of Medicine, Shanghai Jiao Tong University from October 2012 to August 2020 were enrolled. Clinicopathological characteristics of our patients and those reported in previous studies were recorded. The Kaplan-Meier method and univariate and multivariate Cox regression analyses were used for survival analysis. Results Altogether 15 patients from our hospitals and 47 patients from previous studies were included. A total of 55 patients who underwent surgical resection, including R-0 and non-R-0 resection, had significantly longer overall survival compared with the other seven patients. A univariate analysis indicated that patients aged 60 years or older, with jaundice, carcinoid syndrome, non-R-0 resection, and advanced stage were associated with worse survival. A multivariate analysis showed that patients aged 60 years or older, carcinoid syndrome and non-R-0 resection, but not lymphadenectomy and adjuvant chemotherapy, were independently related to reduced survival. Conclusions R-0 resection should be the first-line treatment for GB-NEC. Older age, carcinoid syndrome and non-R-0 resection are independently associated with reduced survival after surgical resection.