脾脏保留对胰体尾切除术治疗胰腺神经内分泌肿瘤预后的影响
| 作者: |
1刘峥嵘
1 首都医科大学附属北京天坛医院 普通外科， 北京 100050 |
| 通讯: |
刘峥嵘
Email: zr1126@yeah.net |
| DOI: | 10.3978/.10.3978/j.issn.1005-6947.2015.09.007 |
摘要
目的：脾脏保留对胰腺神经内分泌肿瘤（PNEN）患者行胰体尾切除术治疗后预后的影响。
方法：回顾性分析2007年2月—2012年7月行胰体尾切除术治疗的PNEN患者32例的临床资料，其中联合脾脏切除21例，脾脏保留11例，比较两组患者术后的生存情况，并对影响患者术后预后的相关因素进行分析。
结果：术后随访时间为13~62个月，平均（41.86±5.14）个月，脾脏保留患者1、3、5年总生存率分别为100%、90.91%、81.82%，而脾脏切除组患者分别为90.48%、80.95%、76.19%，脾脏保留患者的生存率明显优于脾脏切除患者（P<0.05）。单因素分析显示，TNM分期、淋巴结转移及神经或血管浸润、脾脏切除是影响患者预后的相关因素（均P<0.05），而多因素分析显示，仅肿瘤TNM分期为影响患者预后的独立因素（P<0.05）。
结论：胰体尾切除术中予保留脾脏治疗对PNEN患者术后生存有益，但并不是术后预后的独立影响因素。
关键词：
胰腺肿瘤；神经内分泌瘤；脾切除术；预后
方法：回顾性分析2007年2月—2012年7月行胰体尾切除术治疗的PNEN患者32例的临床资料，其中联合脾脏切除21例，脾脏保留11例，比较两组患者术后的生存情况，并对影响患者术后预后的相关因素进行分析。
结果：术后随访时间为13~62个月，平均（41.86±5.14）个月，脾脏保留患者1、3、5年总生存率分别为100%、90.91%、81.82%，而脾脏切除组患者分别为90.48%、80.95%、76.19%，脾脏保留患者的生存率明显优于脾脏切除患者（P<0.05）。单因素分析显示，TNM分期、淋巴结转移及神经或血管浸润、脾脏切除是影响患者预后的相关因素（均P<0.05），而多因素分析显示，仅肿瘤TNM分期为影响患者预后的独立因素（P<0.05）。
结论：胰体尾切除术中予保留脾脏治疗对PNEN患者术后生存有益，但并不是术后预后的独立影响因素。
Influence of spleen preservation on prognosis of patients with pancreatic neuroendocrine neoplasms following distal pancreatectomy
CorrespondingAuthor:LIU Zhengrong Email: zr1126@yeah.net
Abstract
Objective: To investigate the influence of spleen preservation on prognosis of patients with pancreatic neuroendocrine neoplasms (PNEN) following distal pancreatectomy.
Methods: The clinical data of 32 patients with PNEN undergoing surgical resection of the body and tail of the pancreas between February 2007 and July 2012 were analyzed retrospectively. Of the patients, 21 cases had combined splenectomy, and 11 cases had their spleen preserved. The postoperative survival of the two groups of patients was compared, and the prognostic factors for these patients were
analyzed.
Results: The postoperative follow-up ranged from 13 to 62 months, with an average of (41.86±5.14) months. The 1-, 3- and 5-year overall survival rate was 100%, 90.91%, and 81.82% in patients with spleen preservation, and was 90.48%, 80.95% and 76.19% in those having splenectomy respectively, and the postoperative survival in patients with spleen reservation was significantly superior than that in patients undergoing splenectomy (P<0.05). Univariate analysis showed that TNM stage, lymph node metastasis and nerve or vascular invasion, and splenectomy were related factors affecting the prognosis of the patients (all P<0.05), while multivariate analysis showed that only tumor TNM stage was the independent prognostic factor for the patients (P<0.05).
Conclusion: Distal pancreatectomy with spleen preservation is beneficial for postoperative survival of patients with PNEN, but it does not independently affect the postoperative outcomes.
Keywords：
Methods: The clinical data of 32 patients with PNEN undergoing surgical resection of the body and tail of the pancreas between February 2007 and July 2012 were analyzed retrospectively. Of the patients, 21 cases had combined splenectomy, and 11 cases had their spleen preserved. The postoperative survival of the two groups of patients was compared, and the prognostic factors for these patients were
analyzed.
Results: The postoperative follow-up ranged from 13 to 62 months, with an average of (41.86±5.14) months. The 1-, 3- and 5-year overall survival rate was 100%, 90.91%, and 81.82% in patients with spleen preservation, and was 90.48%, 80.95% and 76.19% in those having splenectomy respectively, and the postoperative survival in patients with spleen reservation was significantly superior than that in patients undergoing splenectomy (P<0.05). Univariate analysis showed that TNM stage, lymph node metastasis and nerve or vascular invasion, and splenectomy were related factors affecting the prognosis of the patients (all P<0.05), while multivariate analysis showed that only tumor TNM stage was the independent prognostic factor for the patients (P<0.05).
Conclusion: Distal pancreatectomy with spleen preservation is beneficial for postoperative survival of patients with PNEN, but it does not independently affect the postoperative outcomes.