嗜铬粒蛋白A和突触素的动态变化对胰腺神经内分泌肿瘤患者术后的效果评价

目的 研究胰腺神经内分泌肿瘤患者行腹腔镜手术治疗后的嗜铬粒蛋白A和突触素的动态变化,为患者的确诊及预后情况进行监控.方法 选取2013年3月-2015年3月榆林市第一医院收治的45例胰腺神经内分泌肿瘤患者为对象,所有患者均给予腹腔镜手术治疗,观察手术效果并监测患者术后嗜铬粒蛋白A和突触素的水平.组间比较采用x2检验.所有患者均通过电话随访,随访日期截至2017年1月.结果 TNM分期良性患者与恶性患者在术后嗜铬粒蛋白A的检查中发现其阳性表达率分别为85.0％与53.0％,两组比较差异有统计学意义(P＜0.01).而对应突触素的检查中发现其阳性表达率分别为88.0％与89.0％,两组比较差异无统计学意义(P＞0.05);发生淋巴结转移患者和未发生淋巴结转移患者的嗜铬粒蛋白A阳性表达率分别为47.0％与80.0％,两组比较差异有统计学意义(P＜0.01),对应突触素的检查发现阳性表达率分别为87.0％与87.0％,两组比较差异无统计学意义(P＞0.05).结论 腔镜手术治疗胰腺神经内分泌肿瘤是一种微创、安全的手术方式,患者远期生存率高,采用嗜铬粒蛋白A和突触素对患者的术后水平进行监测,能有效评估疾病的发展与预后,而突触素对患者的预后无任何评估意义.

Dynamic change of chromogranin A and synaptophysin in patients with pancreatic neuroendocrine tumor

Objective To investigate the dynamic changes of chromogranin A in patients with pancreatic neuroendocrine neoplasms after laparoscopic surgery,and to monitor the diagnosis and prognosis of patients with real-time monitoring.Methods Forty-five patients with pancreatic neuroendocrine neoplasms were enrolled in this study from March 2013 to March 2015 in First Hospita of Yulin City.All patients were underwent laparoscopic surgery.The surgical results were observed and the levels of postoperative chromogranin A were monitored.Comparisons between groups were evaluated with the x2 test.Follow-up using telephone interview was performed to detect patients' survival and up to January 2017.Results TNM patients with benign and malignant patients in the postoperative chromogranin A examination found that the positive expression rate were 85.0％ and 53.0％,the difference between the two groups was statistically significant (P ＜ 0.01) and the corresponding synaptophysine examination were 88.0％ and 89.0％ (P ＜ 0.05).The positive expression rates of chromogranin A in patients with lymph node metastasis and non-lymph node metastasis were 47.0％ and 80.0％,respectively (P ＜ 0.01).The positive expression rates of the corresponding synaptophysin were 87.0％ and 87.0％,respectively (P ＞ 0.05).Conclusion Endoscopic surgery for pancreatic neuroendocrine neoplasms is a minimally invasive,safe surgical approach,long-term survival rate of patients with the use of chromogranin A to monitor the level of patients after surgery can effectively assess the development and prognosis of the disease,but the synaptophysine has no significance in assessing the prognosis of the patient.