췌장의 비기능성 내분비 종양의 임상병리학적 특성 및 예후인자

Clinicopathologic Characteristics and Prognostic Factors of Nonfunctioning Endocrine Tumor of the Pancreas

  • 박수민 (서울대학교 의과대학 외과학교실) ;
  • 장진영 (서울대학교 의과대학 외과학교실) ;
  • 강미주 (서울대학교 의과대학 외과학교실) ;
  • 윤유석 (서울대학교 의과대학 분당서울대학교병원 외과학교실) ;
  • 한호성 (서울대학교 의과대학 분당서울대학교병원 외과학교실) ;
  • 조재영 (서울대학교 의과대학 분당서울대학교병원 외과학교실) ;
  • 이승은 (중앙대학교 의과대학 외과학교실) ;
  • 이경분 (서울대학교 의과대학 병리학교실) ;
  • 한인웅 (서울대학교 의과대학 외과학교실) ;
  • 김선회 (서울대학교 의과대학 외과학교실)
  • Park, Soo Min (Department of Surgery, Seoul National University College of Medicine) ;
  • Jang, Jin-Young (Department of Surgery, Seoul National University College of Medicine) ;
  • Kang, Mee Joo (Department of Surgery, Seoul National University College of Medicine) ;
  • Yoon, Yoo-Seok (Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Han, Ho-Seong (Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Cho, Jai Young (Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Lee, Seung Eun (Department of Surgery, Chung-Ang University College of Medicine) ;
  • Lee, Kyoung Bun (Department of Pathology, Seoul National University College of Medicine) ;
  • Han, In Woong (Department of Surgery, Seoul National University College of Medicine) ;
  • Kim, Sun-Whe (Department of Surgery, Seoul National University College of Medicine)
  • 발행 : 2011.02.28

초록

Purpose: Nonfunctioning endocrine tumors of the pancreas have no specific symptoms. Therefore, diagnosis is usually delayed and the malignancy rate at the time of diagnosis is reported to be higher than 50%. However, it is difficult to discriminate malignant from benign nonfunctioning endocrine tumors preoperatively. The purpose of this study was to investigate clinical characteristics of nonfunctioning endocrine tumors of the pancreas, including predictive factors of malignancy and prognostic factors affecting long-term survival. Methods: Between 1992 and 2010, clinicopathological data of 53 patients with nonfunctioning endocrine tumors proven by surgical pathology were reviewed retrospectively. Results: Of the 53 patients, mean age was 54 years-old and the male to female ratio was 1 : 1.2 Median follow up was 32.1 months. At the time of diagnosis, liver metastasis was detected in 4 patients. Curative resection was achieved in 49 patients, and 17% of them had recurrence, which was most common in liver. The overall 5-year survival rate was 85.1%. Both the WHO classification (p<0.001) and AJCC staging (p<0.001) correlated well with long-term survival. Univariate analysis revealed preoperative body weight loss (p<0.001), weak enhancement at the early arterial phase (p=0.043), lymph node metastasis (p<0.001), liver metastasis (p=0.001), perineural invasion (p=0.001), or lymphovascular invasion (p=0.010) as prognostic factors. Conclusion: Nonfunctioning endocrine tumor of the pancreas has favorable survival outcomes. Lymph node metastasis (p<0.001), liver metastasis (p=0.001), perineural invasion (p=0.001), and lymphovascular invasion (p=0.010) are poor prognostic factors.

키워드

참고문헌

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