Clinical features of patients with pancreatic neuroendocrine tumor and influencing factors for prognosis

Objective To investigate the clinical features of patients with pancreatic neuroendocrine tumor( PNET) and the influencing factors for prognosis. Methods A retrospective analysis was performed for the clinical data of 54 patients with pathologically confirmed PNET in The First Affiliated People's Hospital of Shanghai Jiao Tong University from March 2012 to April 2019,and clinical,pathological,and imaging features and prognosis were analyzed. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. The Kaplan-Meier method was used for survival analysis,and the log-rank test was used for comparison between groups.Results Among the 54 patients,there were 19 male patients( 35. 2%) and 35 female patients( 64. 8%). Of all patients,47( 87. 0%)had non-functional tumors and 7( 13. 0%) had functional tumors. There were 17 patients( 31. 5%) with TNM stage Ⅰ tumor,26 patients( 48. 1%) with stage Ⅱ tumor,9 patients( 16. 7%) with stage Ⅲ tumor,and 2 patients( 3. 7%) with stage Ⅳ tumor. According to the World Health Organization pathological grade,24 patients( 46. 2%) had G1 tumor,22( 42. 3%) had G2 tumor,and 6( 11. 5%) had G3 tumor. The patients with unclear boundary of tumor on CT( χ2= 8. 250,P = 0. 010) and MRI( χ2= 6. 048,P = 0. 031) tended to have higher postoperative recurrence rate and mortality rate. Overall survival time ranged from 1 to 86 months,with a 5-year survival rate of92. 0% and a disease-free survival time of 1-71 months. The univariate analysis showed that TNM stage( χ2= 9. 572,P = 0. 023),pathological grade( χ2= 7. 506,P = 0. 023),surgical margin invasion( χ2= 15. 123,P < 0. 001),lymph node metastasis( χ2= 4. 716,P =0. 030),and distant metastasis( χ2= 5. 534,P = 0. 019) were associated with overall survival time in the patients with PNET. Conclusion PNET patients with unclear tumor boundary on CT and MRI tend to have poor prognosis. TNM stage,pathological grade,surgical margin invasion,lymph node metastasis,and distant metastasis are closely associated with the prognosis of patients with PNET.