Pancreatic steatosis and its correlation with clinicopathological features in patients with pancreatic neuroendocrine neoplasms

Background and objective: The incidence of pancreatic neuroendocrine neoplasms (pNENs) has been increasing year by year, and pancreatic steatosis has been paid more and more attention to by clinicians. Our study aims to reveal the correlation between pancreatic steatosis, clinicopathological parameters, and the prognosis of patients with pNENs. Methods: The clinicopathological data of patients with pNENs who underwent surgical resections in our institution from January 2013 to May 2022 were retrospectively analyzed. The mean computed tomography (CT) values of the pancreas and spleen were used to assess the severity of the pancreatic steatosis. Pearson Chi-square test, T test, Mann Whitney U test, Univariate Cox regression, and Multivariate Cox regression were used to explore the relationship between pancreatic steatosis and age, sex, body mass index, tumor type, tumor location, tumor stage, blood lipid, prognosis, and other factors. Results: A total of 122 patients were included in our study, and 19.67% have pancreatic steatosis. The incidence of pancreatic steatosis was significantly higher in patients with fatty liver than in patients without fatty liver (36.8% vs 16.5%, P = .04). In insulinoma, the incidence of pancreatic steatosis in elderly patients was significantly higher than in young and middle-aged patients (41.7% vs 9.3%, P = .025). There was no significant difference in lipid levels between the pancreatic steatosis group and the non-pancreatic steatosis group (P > .05). Kaplan-Meier curves show that the prognosis of stage III/IV patients was significantly worse than that of stage I/II patients (P < .001). However, there was no significant difference in prognosis between patients with and without pancreatic steatosis (P = .404). Conclusion: The incidence of pancreatic steatosis was significantly higher in those with fatty liver than those without fatty liver. There is a high incidence of pancreatic steatosis in elderly patients with insulinoma. American Joint Committee on Cancer (AJCC) stage, but not pancreatic steatosis, significantly affected the prognosis of patients with pNENs.