Clinicopathologic Features and Surgical Treatment of Pancreatic Neuroendocrine Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Chenggang , LIU Rong , ZHAO Zhiming , HU Minggen

Department of Surgical Oncology， Chinese PLA General Hospital， Beijing 100853， China;

Corresponding author：

Keywords：

Pancreatic neoplasm; Neuroendocrine carcinoma; Pathology; Immunohistochemistry; Operation

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Objective 　To investigate the clinicopathologic features and effect of surgical treatment of pancreatic neuroendocrine carcinoma（PNEC）.
Methods 　Clinical data of 31 patients with PNEC treated from Jan. 2008 to Mar. 2012 in our hospital were analyzed，and the expressions of protein CgA，Syn，CD56，CK，VEGF，and Ki-67 were detected by immunohistochemical method. The differences of survival rate and time between radical excision group and palliative surgery group were analyzed by log-rank test.
Results 　Of the 31 patients，22 patients received radical resection and 9 patients received palliative surgery. The positive expression rate of protein CgA，Syn，CD56，CK，and VEGF was 64.52%（20/31），100%（31/31），77.42%（24/31），90.32%（28/31），90.32%（28/31），respectively. According to the percentage of Ki-67 positive cells， 14（45.16%） patients expressed less than 3%，7（22.58%） patients expressed between 3% and 20%， and 10（32.26%）patients expressed more than 20%. The survival rate and time of radical resection group were significantly higher and longer than palliative surgery group（P＜0.001）.
Conclusions 　PNEC is a high potential malignancy and demonstrates aggressive biological behavior. Radical resection can improve the prognosis of patients with PNEC.

Citation： LI Chenggang,LIU Rong,ZHAO Zhiming,HU Minggen,.. Clinicopathologic Features and Surgical Treatment of Pancreatic Neuroendocrine Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(10): 1044-1047. doi: Copy

1.	刘骞，黄帅，刘剑坡，等. 胰腺神经内分泌癌的诊断及外科治疗（附10例临床报告）[J]. 实用肿瘤杂志， 2011， 26(3)： 262-265.
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16.	Tonelli F， Giudici F， Fratini G， et al. Pancreatic endocrinetumors in multiple endocrine neoplasia type 1 syndrome：review of literature[J]. Endocr Pract， 2011， 17(Suppl 3)：33-40.
17.	楼文晖. 转移性胰腺神经内分泌肿瘤综合治疗[J]. 中国实用外科杂志， 2010，30(9)： 745-748.
18.	Ochiai T， Masuda T， Nishizawa M， et al. Curative resection of a huge malignant pancreatic endocrine tumor by pancreatoduodenectomy with portal and superior mesenteric vein resection and reconstruction using the right ovarian vein：report of a case[J]. Surg Today， 2011， 41(9)：1260-1265.
19.	Tsuchikawa T， Kondo S， Hirano S， et al. Distal pancreatectomy and portal vein resection without vascular reconstruction for endocrine tumors with massive intraportal growth： report of a case[J]. Hepatogastroenterology， 2011， 58(107-108)： 1029-1031.
20.	Strosberg JR， Choi J， Cantor AB， et al. Selective hepatic artery embolization for treatment of patients with metastatic carcinoid and pancreatic endocrine tumors[J]. Cancer Control， 2006， 13(1)：72-78.
21.	Marrache F， Vullierme MP， Roy C， et al. Arterial phase enhan-cement and body mass index are predictors of response to chemoembolisation for liver metastases of endocrine tumours[J]. Br J Cancer， 2007， 96(1)：49-55.
22.	Saif MW， Ng J， Chang B， et al. Is there a role of radiotherapy in the management of pancreatic neuroendocrine tumors (PNET)?[J]. JOP， 2012，13(2)：174-176.
23.	Strosberg J， Hoffe S， Gardner N， et al. Effective treatment of locally advanced endocrine tumors of the pancreas with chemoradiotherapy[J]. Neuroendocrinology， 2007， 85(4)： 216-220.
24.	Pavlidis TE， Psarras K， Symeonidis NG， et al. Current surgical management of pancreatic endocrine tumor liver metastases[J]. Hepatobiliary Pancreat Dis Int， 2011， 10(3)： 243-247.
25.	Jeong HK， Roh SY， Hong SH， et al. Pancreatic endocrinetumors：a report on a patient treated with sorafenib[J]. J Korean Med Sci， 2011， 26(7)： 954-958.

1. 刘骞，黄帅，刘剑坡，等. 胰腺神经内分泌癌的诊断及外科治疗（附10例临床报告）[J]. 实用肿瘤杂志， 2011， 26(3)： 262-265.
2. Fendrich V， Waldmann J， Bartsch DK， et al. Surgical management of pancreatic endocrine tumors[J]. Nat Rev Clin Oncol， 2009， 6(7)： 419-428.
3. Oberg K. Pancreatic endocrine tumors[J]. Semin Oncol， 2010， 37(6)： 594-618.
4. 庄岩，杨尹默. 胰腺神经内分泌肿瘤外科治疗[J]. 中国实用外科杂志， 2010，30(9)： 742-745.
5. 朱雄增. 胰腺神经内分泌肿瘤研究进展的认识[J]. 诊断学理论与实践， 2011，10(4)： 297-300.
6. 李宁宁，白春梅. 胃肠胰腺神经内分泌肿瘤治疗进展[J]. 癌症进展， 2010， 8(4)： 352-356.
7. 石毅，孙跃明，苗毅，等. 无功能胰腺神经内分泌癌的诊断与外科治疗[J]. 中国普通外科杂志， 2007， 16(10)： 939-942.
8. Bosman FT， Cameiro F， Hruban RH， et al. WHO classification of tumours of the digestive system[M]. Fourth Edition. Lyon：IARC Press，2010：485-500.
9. 中国胃肠胰神经内分泌肿瘤病理专家组. 中国胃肠胰神经内分泌肿瘤病理学诊断共识[J]. 中华病理学杂志， 2011， 40(4)： 257-262.
10. Maschuw K， Fendrich V， Langer P， et al. Impact of CT-based diagnostic imaging on management and outcome of nonfunctioning pancreatic tumors[J]. Langenbecks Arch Surg， 2011， 396(8)： 1181-1186.
11. Bettini R， Partelli S， Boninsegna L， et al. Tumor size correlates with malignancy in nonfunctioning pancreatic endocrine tumor[J]. Surgery， 2011， 150(1)：75-82.
12. Haynes AB， Deshpande V， Ingkakul T， et al. Implications of incidentally discovered， nonfunctioning pancreatic endocrine tumors：short-term and long-term patient outcomes[J]. Arch Surg， 2011， 146(5)： 534-538.
13. Abu Hilal M， McPhail MJ， Zeidan BA， et al. Aggressive multi-visceral pancreatic resections for locally advanced neuroendocrine tumours. Is it worth it?[J]. JOP， 2009， 10(3)： 276-279.
14. Schurr PG， Strate T， Rese K， et al. Aggressive surgery improves long-term survival in neuroendocrine pancreatic tumors： an institutional experience[J]. Ann Surg， 2007， 245(2)：273-281.
15. Norton JA， Harris EJ， Chen Y， et al. Pancreatic endocrinetumors with major vascular abutment，involvement，or encasement and indication for resection[J]. Arch Surg， 2011， 146(6)：724-732.
16. Tonelli F， Giudici F， Fratini G， et al. Pancreatic endocrinetumors in multiple endocrine neoplasia type 1 syndrome：review of literature[J]. Endocr Pract， 2011， 17(Suppl 3)：33-40.
17. 楼文晖. 转移性胰腺神经内分泌肿瘤综合治疗[J]. 中国实用外科杂志， 2010，30(9)： 745-748.
18. Ochiai T， Masuda T， Nishizawa M， et al. Curative resection of a huge malignant pancreatic endocrine tumor by pancreatoduodenectomy with portal and superior mesenteric vein resection and reconstruction using the right ovarian vein：report of a case[J]. Surg Today， 2011， 41(9)：1260-1265.
19. Tsuchikawa T， Kondo S， Hirano S， et al. Distal pancreatectomy and portal vein resection without vascular reconstruction for endocrine tumors with massive intraportal growth： report of a case[J]. Hepatogastroenterology， 2011， 58(107-108)： 1029-1031.
20. Strosberg JR， Choi J， Cantor AB， et al. Selective hepatic artery embolization for treatment of patients with metastatic carcinoid and pancreatic endocrine tumors[J]. Cancer Control， 2006， 13(1)：72-78.
21. Marrache F， Vullierme MP， Roy C， et al. Arterial phase enhan-cement and body mass index are predictors of response to chemoembolisation for liver metastases of endocrine tumours[J]. Br J Cancer， 2007， 96(1)：49-55.
22. Saif MW， Ng J， Chang B， et al. Is there a role of radiotherapy in the management of pancreatic neuroendocrine tumors (PNET)?[J]. JOP， 2012，13(2)：174-176.
23. Strosberg J， Hoffe S， Gardner N， et al. Effective treatment of locally advanced endocrine tumors of the pancreas with chemoradiotherapy[J]. Neuroendocrinology， 2007， 85(4)： 216-220.
24. Pavlidis TE， Psarras K， Symeonidis NG， et al. Current surgical management of pancreatic endocrine tumor liver metastases[J]. Hepatobiliary Pancreat Dis Int， 2011， 10(3)： 243-247.
25. Jeong HK， Roh SY， Hong SH， et al. Pancreatic endocrinetumors：a report on a patient treated with sorafenib[J]. J Korean Med Sci， 2011， 26(7)： 954-958.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinicopathologic Features and Surgical Treatment of Pancreatic Neuroendocrine Carcinoma

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