摘要
目的探讨胰腺癌的胰实质期CT增强与病理分级、瘤体实质细胞处的微血管密度(microvessel den-sity,MVD)、血管内皮生长因子(vascular endothelial growth factor,VEGF)表达的相关性。方法选择经手术切除的胰腺癌患者30例,手术前均行CT增强扫描,观察胰腺癌胰实质期强化程度和形式;并对其手术标本行HE染色和免疫组化标记,对胰腺癌的CT强化状况、病理级别、瘤体实质细胞处的MVD和VEGF的表达行相关性分析。结果胰腺癌CT胰实质期瘤体强化程度、形式和其恶性度高低呈显著负相关(r=0.733,t=5.708,P<0.001),和瘤体实质细胞处MVD计数显著负相关(r=0.778,t=6.551,P<0.001);胰腺癌的病理分级和瘤体实质细胞处MVD计数正相关(r=0.437,t=7.574,P<0.05),而与VEGF表达无关(r=-0.240,t=-1.306,P>0.05)。VEGF阳性表达组MVD为57.7±11.1,VEGF阴性表达组MVD为44.6±12.2,两者差异有统计学意义(t=3.018,P<0.05)。结论胰腺癌CT胰实质期增强程度高低能反映肿瘤的恶性程度及瘤体实质细胞处MVD计数。胰腺癌的恶性度高低、VEGF表达均与MVD计数密切相关。
Objective To summarize the clinical feature and the surgical experience of primarily gallbladder carcinoma（PGC）,evaluate the prognosis of PGC with different surgical treatment and the factors influencing the prognosis of PGC.Methods The clinic data of 103 patients with gallbladder cancers were analyzed retrospectively to reveal the relationship among of the stage of tumor,surgical modes and prognostic factors.Results One hundred and three patients were followed-up.The mean survival time was（19.6±18.4） months,the 1,3 and 5-year survival rate were 55.0%,25.0% and 8.0%.The 1,3 and 5-year survival rate were 81.0%,42.0% and 19.0% in radical resection group,significantly higer than that in palliative operation group and laparotomy biopsy group（P0.05）.The mean survival time was（16.17±3.67）months in extended radical resection group,which was longer than that in the palliative operation group（9.22±1.125）months（P0.05）.Multivariate analysis revealed that tumor,node,metastases stage and therapeutic interventions were independent prognostic factors for gallbladder cancer.Conclusion PGC is difficult to diagnose in early stage because it has no typical symptoms.The key point to improve the prognosis is diagnose early and had radical resection.We should do cholecystectomy in patient with high risk of PGC,or regular follow-up if the patient refused operation.We should give individual and active treatment to advanced PGC patients,the radical resection or the extended radical resection is effective way to improve the prognosis.
出处
《肝胆胰外科杂志》
CAS
2010年第5期384-388,共5页
Journal of Hepatopancreatobiliary Surgery
基金
温州市科技局科技计划项目(Y2005A096)
