摘要
目的探讨胰腺腺泡细胞癌(PACC)的临床病理学特点、组织学特征、外科治疗、预后。方法收集整理2010年1月到2020年1月在郑州大学第一附属医院接受外科手术治疗或穿刺活检病理报告确诊为PACC患者的临床资料,分析其临床表现、病理学特征、治疗经过、随访情况。结果共收集到具有完整病例资料的PACC患者23例,其中接受外科手术治疗的PACC患者10例。男16例,女7例,男女比例为2.29∶1,年龄为6~70岁,平均(54.52±14.79)岁。初次就诊时症状以腹痛腹胀、黄疸、消瘦、腹泻为主。肿瘤部位为胰头7例(30.43%)、胰尾部7例(30.43%)、胰体尾6例(26.09%)、胰体部2例(8.70%)、胰头体尾1例(4.35%)。入院糖类抗原19-9(CA19-9)升高8例(34.78%)、CA125升高6例(26.09%)、甲胎蛋白(AFP)升高5例(21.74%)、癌胚抗原(CEA)升高3例(12.04%)、CA153升高2例(8.70%)。术前均未明确诊断,所有患者均经术后或者穿刺活检常规病理确诊为PACC,病理确诊率为100%。10例外科手术治疗手术方式:胰体尾切除+脾切除术5例、胰十二指肠切除术2例、腹腔肿物+脾切除术2例、胆囊空肠吻合术1例。随访:9例患者生存(39.13%),8例患者死亡(34.78%),6例(26.09%)患者失联。平均生存期为12(6,36.5)个月。17例成功随访患者中1、3、5 a生存率分别为52.94%、23.53%、11.76%。结论PACC是一种临床上少见的胰腺恶性肿瘤,其临床术前确诊率低,外科根治性手术切除后可长期存活,预后较好。
Objective To investigate the clinicopathological features,histological features,surgical treatment and prognosis of pancreatic acinar cell carcinoma(PACC).Methods The clinical data of patients with PACC confirmed by surgical treatment or puncture biopsy pathological reports in the First Affiliated Hospital of Zhengzhou University from January 2010 to January 2020 were collected and analyzed for their clinical manifestations,pathological characteristics,treatment process and follow-up.Results A total of 23 patients with complete case data were collected,including 10 patients with PACC who underwent surgical treatment.There were 16 males and 7 females,with a male to female ratio of 2.29∶1.The patients age was 6-70 years old,with an average age of(54.52±14.79)years old.The symptoms at the first visit were abdominal pain,abdominal distension,jaundice,emaciation and diarrhea.The tumor sites included 7 cases of pancreatic head(30.43%),7 cases of pancreatic tail(30.43%),6 cases of pancreatic body and tail(26.09%),2 cases of pancreatic body(8.70%)and 1 case of pancreatic head,body and tail(4.35%).Eight patients(34.78%)had increased carbohydrate antigen 19-9(CA19-9),6(26.09%)had increased CA125,5(21.74%)had increased alpha-fetoprotein(AFP),3(12.04%)had increased carcinoembryonic antigen(CEA),and 2(8.70%)had increased CA153.No definite diagnosis was made before surgery.All patients were diagnosed as PACC by routine pathology after surgery or puncture biopsy,and the pathologic diagnosis rate was 100%.Ten cases were treated by surgical operation.Five cases were treated by pancreatectomy combined with splenectomy,2 cases by pancreaticoduodenectomy,2 cases by abdominal mass combined with splenectomy,and 1 case by cholecystojejunostomy.During follow-up,9 patients survived(39.13%),8 died(34.78%),and 6(26.09%)lost contact.The mean survival time was 12(6,36.5)months.Among the 17 patients successfully followed up,the 1-,3-and 5-year survival rates were 52.94%,23.53%and 11.76%,respectively.Conclusion PACC is a rare clinical malignant tumor of the pancreas,with a low preoperative diagnosis rate,long-term survival and a good prognosis after radical surgical resection.
作者
刘豪
范小月
乔师师
LIU Hao;FAN Xiaoyue;QIAO Shishi(Department of Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Pathology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《河南医学研究》
CAS
2021年第8期1373-1377,共5页
Henan Medical Research
关键词
胰腺
腺泡细胞癌
外科治疗
临床病理
预后
pancreas
acinar cell carcinoma
surgical treatment
clinicopathology
the prognosis
