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目的分析无功能胰岛细胞肿瘤(NFICCs)的临床病理特征,探讨其临床诊治方法。方法回顾性分析43例无功能胰岛细胞肿瘤的临床、病理及预后资料。采用Kaplan-Meier生存曲线分析及Log rank统计分析。结果43例无功能胰岛细胞肿瘤患者中,无功能胰岛细胞癌(NFICC)28例,无功能胰岛细胞瘤(BNFICTs)15例。临床症状以腹痛、恶心、呕吐、乏力及腹部肿块多见。术前B超及CT均能确定胰腺肿块。肿瘤位于胰头部21例,胰尾部10例,胰体部6例,体尾部5例,多发性1例。全组总的手术切除率为90.7%,根治切除率为69.8%,姑息手术20.9%。NFICC患者手术切除率及根治性切除率分别为78.6%和60.7%。NFICC患者的5年及10年生存率分别为58.1%和29.0%。女性、30岁以下、根治性手术以及肿瘤直径<10 cm的患者预后较好。多因素回归分析证实,手术方法是惟一的预后影响因素(P=0.007)。结论无功能胰岛细胞肿瘤好发于年轻女性,手术切除率较高。患者采取手术治疗、特别是根治性手术,可以获得较理想的远期疗效。
Objective To analyze the clinicopathological features of non-functional islet cell tumor (NFICCs) and to explore the clinical diagnosis and treatment methods. Methods Retrospective analysis of 43 cases of non-functional islet cell tumor clinical, pathological and prognostic data. Kaplan-Meier survival curve analysis and Log rank statistical analysis. Results Of the 43 patients with non-functioning islet cell tumor, 28 were non-functioning islet cell carcinoma (NFICC) and 15 were non-functioning islet cell tumors (BNFICTs). Clinical symptoms to abdominal pain, nausea, vomiting, fatigue and abdominal mass more common. Preoperative ultrasound and CT can determine the pancreatic mass. Tumor in the head of the pancreas in 21 cases, 10 cases of pancreatic tail, pancreatic body in 6 cases, 5 cases of body tail, multiple cases in 1 case. The total surgical resection rate was 90.7%, radical resection rate was 69.8%, palliative surgery 20.9%. The surgical resection rate and radical resection rate in patients with NFICC were 78.6% and 60.7%, respectively. The 5-year and 10-year survival rates of patients with NFICC were 58.1% and 29.0%, respectively. Women, under 30 years of age, radical surgery, and tumors <10 cm in diameter have a better prognosis. Multivariate regression analysis confirmed that surgery was the only prognostic factor (P = 0.007). Conclusion Non-functional islet cell tumors occur in young women, the surgical resection rate is high. Surgical treatment of patients, especially radical surgery, you can get better long-term efficacy.