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Management of nonfunctioning islet cell tumors

机译:无功能的胰岛细胞瘤的治疗

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摘要

AIM: To more clearly define the clinical and pathological characteristics and appropriate diagnosis and treatment of nonfunctioning (NFICTs) islet cell tumors, and to review our institutional experience over the last 30 years.METHODS: The records of 43 patients confirmed to have nonfunctioning islet cell tumors of pancreas were retrospectively reviewed. Survival was estimated by the Kaplan-Meier methods and potential risk factors for survival were compared with the log-rank tests.RESULTS: The mean age was 31.63 years (range, 8 to 67 years). There were 7 men and 36 women. Twenty-eight patients had a confirmed diagnosis of nonfunctioning islet cell carcinoma (NFICC) and benign islet cell tumors were found in 15 patients. The most common symptoms in patients with NFICTs were abdominal pain (55.8%), nausea and/or vomiting (32.6%), fatigue (25.6%) and abdominal mass (23.3%). Preoperative ultrasonic and computed tomography localized the tumors in all patients. Forty-three NFICTs were distributed throughout the pancreas, with 21 located to the right of the superior mesenteric vessels, 10 in the body of the pancreas, 6 in the tail of the pancreas, and multiple tumors were found in one patient. Thirty-nine of 43 patients (91%) underwent surgical resection. Surgical treatment was curative in 30 patients (70%) and palliative in 9 (21%). The resectability and curative resection rate in patients with NFICC of pancreas were 89% and 61%, respectively. The overall cumulative 5-year and 10-year survival rates for patients with NFICC were 58.05% and 29.03%, respectively. Radical operation and diameter of cancer small than 10 cm were positive prognostic factors in females younger than 30 years old. Multivariate Cox regression analysis indicated that radical operation was the only independent prognostic factor, P = 0.007.CONCLUSION: Nonfunctioning islet cell tumors of pancreas are found mainly in young women. The long-term results for patients undergone surgery, especially curative resection are good.
机译:目的:为了更清楚地定义胰岛功能不全(NFICT)细胞瘤的临床和病理特征以及适当的诊断和治疗方法,并回顾我们过去30年的机构经验。方法:43名确诊胰岛功能不全的患者的记录回顾性回顾胰腺肿瘤。通过Kaplan-Meier方法评估生存率,并将生存的潜在危险因素与对数秩检验进行比较。结果:平均年龄为31.63岁(范围为8至67岁)。男7名,女36名。 28名患者确诊为无功能性胰岛细胞癌(NFICC),在15例患者中发现了良性胰岛细胞瘤。患有NFICT的患者最常见的症状是腹痛(55.8%),恶心和/或呕吐(32.6%),疲劳(25.6%)和腹部肿块(23.3%)。术前超声和计算机断层扫描在所有患者中定位了肿瘤。胰腺中分布着43种NFICT,其中21处位于肠系膜上血管的右侧,胰体中10处,胰尾部6处,一名患者发现了多种肿瘤。 43例患者中有39例(91%)接受了手术切除。手术治疗治愈30例(70%),姑息治疗9例(21%)。胰腺NFICC患者的可切除性和治愈率分别为89%和61%。 NFICC患者的5年和10年总累积生存率分别为58.05%和29.03%。根治性手术和直径小于10 cm的癌症是30岁以下女性的阳性预后因素。多因素Cox回归分析表明,根治性手术是唯一的独立预后因素,P = 0.007。结论:胰腺无功能性胰岛细胞瘤主要见于年轻女性。对于接受手术治疗的患者,尤其是根治性切除术,长期效果良好。

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