中药预防高分化胰腺神经内分泌肿瘤根治术后复发的临床研究

发布时间：2019-01-10 09:46

【摘要】：目的回顾性的分析高分化胰腺神经内分泌肿瘤(pNENs)术后患者的临床病理资料,探讨影响pNENs术后复发的相关危险因素及中药预防高分化pNENs术后复发的作用。方法回顾性的分析了 2012年1月至2016年12月中日友好医院47例高分化pNENs术后患者的临床病理资料,分析高分化pNENs术后复发的危险因素。根据患者术后是否接受中药辅助治疗,分为中药组和对照组,比较两者复发率和无病生存期(DFS)有无差异,并行pNETs患者术后复发危险因素的单因素及多因素分析。结果全组收集47例pNENs术后患者,其中38例(80.9%)为无功能pNETs,9例(19.1%)为功能性pNETs。肿瘤位于胰头共16例(34.0%),胰体尾15例(31.9%),胰尾9例(19.1%),胰体3例(6.4%)。肿瘤大小在0.3cm至13cm之间(4.02±2.51)。病理分级中,G1级共13 例(27.7%),G2 级共 32 例(68.1%)。临床分期中 T1:9 例(19.1%),T2:20例(42.6%),T3:13(27.7%)。N0:28 例(59.6%),N1:16 例(34%)。IA 期共 9 例(19.1%),IB期13期(27.7%),ⅡA期6例(12.8%),IHB期14例(29.8%)。全组病人共有22例(46.8%)患者接受中药治疗,共有20例(42.6%)患者未接受任何术后辅助治疗,有5例(10.6%)患者接受其他治疗,全组患者中共有17例(36.2%)患者出现术后复发。中药组共22例,其中有5例复发,1年复发率为5.9%,2年复发率为25.1%,3年复发率为25.1%,估计中位DFS为72个月(95CI 6.3,137.7月)。对照组共20例,共有8复发,1年复发率20%,2年复发率52.6%,3年复发率为68.4%,估计中位DFS为23个月(95CI 11.1,34.9月)。单因素分析表明Ki67指数,临床分期,中药辅助治疗,淋巴结转移,肿瘤是否超出胰腺,切缘性质与pNETs患者术后复发相关(P0.05),多因素分析结果表明淋巴结阳性、Ki67阳性指数"g10%是pNETs患者术后复发的独立危险因素(p0.05),中药术后辅助治疗是预防pNETs患者术后复发的保护性因素。结论淋巴结转移、Ki67阳性指数会10%是pNETs患者术后复发的独立危险因素,而中药术后辅助治疗是预防pNETs患者术后复发的保护性因素,中药在降低pNENs术后复发率、延长DFS有统计学意义。
[Abstract]:Objective to retrospectively analyze the clinicopathological data of well-differentiated pancreatic neuroendocrine tumors after (pNENs), and to explore the risk factors affecting the recurrence of pNENs and the role of Chinese medicine in preventing the recurrence of well-differentiated pNENs. Methods the clinicopathological data of 47 patients after well-differentiated pNENs in China-Japan Friendship Hospital from January 2012 to December 2016 were analyzed retrospectively and the risk factors for recurrence of well-differentiated pNENs were analyzed. Patients were divided into Chinese medicine group and control group according to whether they received Chinese medicine adjuvant therapy after operation. The recurrence rate and disease-free survival (DFS) were compared between the two groups. The single factor and multivariate analysis of the risk factors of recurrence in patients with pNETs were also analyzed. Results 47 cases of postoperative pNENs were collected, of which 38 cases (80.9%) were nonfunctional pNETs,9 cases (19.1%) were functional pNETs.. The tumors were located in the head of pancreas in 16 cases (34.0%), the body and tail of pancreas in 15 cases (31.9%), the tail of pancreas in 9 cases (19.1%) and the body of pancreas in 3 cases (6.4%). The tumor size ranged from 0.3cm to 13cm (4.02 卤2.51). 13 cases (27.7%) were in G1 grade and 32 cases (68.1%) in G2 grade. There were 9 cases (19.1%) of T 1:, 20 cases (42.6%) of T 2:, 13 cases of T 3: 13 (27.7%), 28 cases of N 0: 28 (59.6%), 16 cases of N 1: 16 (34% of). IA), 9 cases (19.1%). IB stage 13 (27.7%), stage 鈪，

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