针对白人患者的NET指南可能不适合亚洲患者
Ahmer Irfan1, Katherine E McElroy1, Rui Zheng-Pywell1
1The Department of Surgery, University of Alabama at Birmingham, 1808 7th Avenue S, Birmingham, AL, 35233, USA.
American journal of surgery
|December 6, 2024
概括
目前的胰腺神经内分泌瘤 (pNET) 准则可能不适用于亚洲患者. 这项研究发现,虽然瘤大小与两种种族的淋巴结转移相关,但亚洲患者在较大的瘤大小 (≥3厘米) 中的风险较低.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 癌症护理中的种族差异
背景情况:
- 胰腺神经内分泌瘤 (pNETs) 显示出受种族影响的可变生存结果.
- 现有的基于pNET的大小的治疗指南主要是从对白人患者群体的研究中建立起来的.
- 需要评估这些指导方针在不同种族人口统计学中的通用性.
研究的目的:
- 为了研究瘤大小和淋巴结转移 (LNM) 在白人和亚洲患者的发生率之间的关系.
- 评估目前基于大小的pNET外科切除指南在多样化的患者群体中的适用性.
- 为了确定pNET进展和转移模式的潜在种族差异.
主要方法:
- 使用国家癌症数据库 (NCDB) 进行了对4977名低度,切除,非功能,零星,非转移性pNET患者的多机构分析.
- 奇平方测试和逻辑回归模型被用来分析初级瘤大小 (PTS),种族和淋巴结转移 (LNM) 发生率之间的相关性.
- 总体存活率是使用卡普兰-梅尔法来评估的.
主要成果:
- 与白人患者相比,亚洲患者的瘤平均较小 (3.0厘米对3.9厘米).
- 白人患者的LNM发病率较高 (27%对19%),R0切除的可能性更高.
- 虽然LNM的发病率随着瘤大小的增加而增加,但亚洲患者在瘤大小≥3厘米 (28.2%对39.5%) 的LNM的可能性较低.
结论:
- 目前基于pNET的基于大小的外科手术指南主要在白人患者中开发,可能不适用于亚洲人群.
- 与白人患者相比,亚洲患者患有pNET的淋巴结转移的风险不会随着原发性瘤大小的增加而以相同的速度升级.
- 需要进一步的研究来完善pNET管理策略,考虑到瘤行为的种族差异.
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