摘要
目的探讨胰腺黏液非囊性癌的临床病理特点、诊治方法和预后。方法回顾性分析中国医学科学院肿瘤医院收治的11例胰腺黏液非囊性癌的临床病理及随访资料。结果11例患者男性6例，女性5例。年龄47～76岁，平均60．5岁。8例以上腹部不适为首发症状，1例以腹部肿块为首发症状，2例伴有黄疸。肿瘤标志物CA199均升高，6例超过正常值的5倍。影像学检查表现为胰腺密度不均的实性占位病变，边界不清。肿瘤位于胰头5例，胰体尾6例，直径4—11cm，平均6．5cm。11例患者均行手术探查，4例伴肝转移，1例伴腹腔广泛转移，9例行姑息性手术，2例行根治性切除，无围手术期死亡，免疫组化MUC-1均为阴性、MUC-2均为阳性，PCNA和Ki-67均为阳性。术后2例姑息性手术患者失访，其余均于5～22个月内死亡，患者平均生存期10个月。结论胰腺黏液非囊性癌主要依赖病理学诊断，预后差，其生物学特性有待于进一步研究。
Objective To explore the clinicopathological features, diagnosis and therapy for pancreatic mucinous noncystic adenocarcinoma（MNAC）. Methods Eleven MNAC cases treated in our hospital were studied retrospectively. The clinical and pathologic data were reviewed. Results Of the 11 patients, 6 were male and 5 were female. The age ranged from 47 to 76 years with average of 60. 5 years. The main complains included upper abdominal discomfort in 8 cases, abdominal mass in 1 case and jaundice in 2 cases. CA199 serum test was positive in all patients and 5-fold high above normal value in 6 cases. The preoperative radiography of MNAC was usually not specific. Tumors located in the head in 5 cases and in the body and tail of the pancreas in 6 cases. The diameter of the tumor was 4 - 11 cm with average of 6. 5 cm. All cases underwent operation, with radical resection in 2 cases. Liver or abdominal metastasis was found in 5 cases. Postoperative immunohistochemistry showed that MUC-1 was negative in all patients. MUC-2, PCNA and Ki-67 Were positive in all patients. All 9 cases that were followed-up died within 5 -22 months ,with an average survival time of 10 months. Conclusions The diagnosis of MNAC depends on pathology. Its prognosis is poor.
出处
《中华普通外科杂志》
CSCD
北大核心
2008年第10期750-752,共3页
Chinese Journal of General Surgery
关键词
胰腺肿瘤
诊断
治疗
预后
黏液非囊性癌
Pancreatic neoplasms
Diagnosis
Therapy
Prognosis
Mucinous noncystic adenocarcinoma
