臺灣博碩士論文加值系統

神經內分泌瘤為一相對罕見之腫瘤，此類腫瘤可產生多樣功能性或非功能性之荷爾蒙，涵蓋的範圍包括多處之位置及不同之細胞來源，近年來根據美國及北歐癌症登記的報告分析，此類腫瘤的發生率有逐年增加的趨勢，而在亞洲這方面的資料是很欠缺的，本計畫是利用台灣癌症登記資料庫的資料，我們調查從1996年1月1日至2008年12月31日台灣神經內分泌瘤的發生率及存活，並和歐美的結果加以分析比較，在本研究分析的時間內，診斷為神經內分泌瘤的個案一共有2187個，其中62%為男性，平均診斷年齡為57.9歲，發生率從1996年每十萬人口中有0.3個增加到2008年的1.51個，最常見發生的部位是直腸(25.4%)，其次是肺/支氣管 (20%)，第三位則為胃部(7.4%)，全部個案的5年存活率為50.4%，女性(61.8%)優於男性(43.4%)，依部位來分，最好的是直腸(80.9%)，依次為闌尾(75.7%)、及乳房(64.8%)，與美國及挪威的報告比較，台灣的神經內分泌瘤之發生率較他們明顯偏低，好發的部位也有差異，長期的存活則相似，而引起神經內分泌瘤的病因至今仍不是很清楚，這一方面的了解值得進一步研究，以利於在預防及治療神經內分泌瘤上能有進一步的發展。

Neuroendocrine tumors (NETs) are neoplasms originating from neuroendocrine cells located throughout the body, most commonly in lung and gastrointestinal tract. NETs may secret various peptides and some of which may cause clinical symptoms (also known as “functioning” NET). Most NETs have an indolent course, whereas some proliferate rapidly and metastasize to distant organs. The incidence rate of NETs was noticed to increase rapidly from cancer registry database in US and Norway recently. The epidemiology of NETs is not well illustrated, particularly for Asian countries. In this study, we analyzed the incidence and survival of NETs diagnosed in Taiwan from January 1,1996 to December 31, 2008, which were calculated from the data of Taiwan Cancer Registry (TCR) and compared to those of the Norway Cancer Registry (NCR) and the US Surveillance, Epidemiology, and End Results (SEER). During the study period, a total of 2,187 NET cases were diagnosed in Taiwan, with predominantly males (62%) and a mean age of 57.9 years-old. The NETs incidence increased from 0.30 per 100,000 in 1996 to 1.51 per 100,000 in 2008. The most common primary sites were rectum (25.4%), lung and bronchus (20%) and stomach (7.4%). The 5-year survival was 50.4% for all NETs, with 43.4% for men and 61.8% for women (P < 0.0001). The best 5-year survivals for NETs by sites were rectum (80.9%), appendix (75.7%), and breast (64.8%). Compared to the data of Norway and US, the NETs incidence in Taiwan is lower and the major primary sites are different, whereas the long-term outcome is similar. More studies on the pathogenesis of NETs are warranted to devise preventive strategies and improve the treatments for NETs.

一、中文摘要 P. 3
二、英文摘要 P. 4
三、序言 P. 5
四、研究背景 P. 7
五、研究目的 P.11
六、研究策略架構圖.材料與方法 P.12
七、結果 P.21
八、討論 P.29
九、參考文獻 P.43
十、附圖.附表 P.52
十一、附錄 P.95

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