【作者】 周俊；

【导师】 丁克峰；

【作者基本信息】 浙江大学 ， 肿瘤学， 2012， 硕士

【摘要】 背景与目的：目前胃肠胰神经内分泌肿瘤的预后因素标准存在诸多分歧,本文通过对胃肠胰神经内分泌肿瘤的临床病理特征对预后影响的分析,为能有效预测该病临床疗效与预后提供依据。资料与方法：本文回顾性分析123例2000年3月至2011年3月期间在浙江大学附属第二医院经手术治疗并病理诊断为胃肠胰神经内分泌肿瘤的患者临床资料,主要观察终点为总生存期(overal survival,OS),通过Kaplan-Meier方法描绘患者生存曲线。采用Log-rank法检验GEP-NETs临床病理特征与预后关系。采用多因素Cox回归分析法分析各项因素与OS是否存在相关性。结果：本研究中123例患者中59例存活,总体的中位生存时间46.1月,1、3、5年生存率分别为69%、37.4%、29.6%。单因素分析表明年龄、肿瘤侵犯程度、大小、血管浸润、手术切缘、淋巴结转移及远处转移等因素与该病预后有显著相关(p<0.05),性别(P=0.784)、肿瘤部位(P=0.988)则预后则未见显著相关。COX多因素进一步分析结果表明年龄(HR=1.93,95%CI1.06-3.50)、远处转移(HR=1.83,95%CI1.24-2.72)是该病生存预后的独立预后指标。结论：年龄、大小、肿瘤侵犯程度、血管浸润、手术切缘、淋巴结转移及远处转移等显著影响胃肠胰神经内分泌肿瘤患者生存预后。特别是年龄大于60岁及有远处转移是患者预后差的独立预后指标。更多还原

【Abstract】 Background/Purpose:There is lacking in sufficiency standard of prognostic factors for Gastro-enteropancreatic Neuroendocrine Tumors (GEP-NETs) In recent clinical practice.. It is essential to predict GEP-NETs’prognosis effectively by analysis of GEP-NETs’ clinical characteristic.Materials and Methods:We analysed retrospectively123patients who were diagnosed pathologically as GEP-NETs and treated by the operation in Second Affiliated Hospital Zhejiang University School of Medicine between March2000and March2011. The primary endpoint was overall survival (OS). The association of patient survival with was evaluated by Kaplan-Meier method.. The relationships of clinical characteristics and overall survival were analyzed using Log-rank test and multivariate Cox regression analysis. Results:There were59patients alive among123patients. The overall median survival duration was46.1months, the overall survival rate for1,3and5year was69%、37.4%、29.6%. The result of univariate analysis indicated that the factors like patients’ age, tumor size, depth of invasion, vascular infiltration, incisal margin, lymph node metastasis and distant metastasis were found to be significantly associated with the prognosis(p<0.05), while gender(P=0.784)and tumor site(P=0.988)had no relationship. The multivariate Cox regression analysis further showed that the age(HR=1.93,95%CI1.06-3.50) and distant metastasis (HR=1.83,95%CI1.24-2.72) were the major independent prognosis indicators.Concisions:The factors including patients’age, tumor size, depth of invasion, vascular infiltration, incisal margin, lymph node metastasis and distant metastasis can impact patients’ prognosis of GEP-NETs obviously. Especially, age>60years and distant metastasis were the major independent factors of the poor prognosis.更多还原