28例胰腺体尾部癌的诊断与外科治疗  

Diagnosis and surgical treatment of 28 cases of carcinoma of pancreatic body and tail

作　　者：唐春[1] 刘宏鸣[1] 刘孟刚[1] 陈平[1] 杨俊涛[1] 袁涛[1] 吴刚[1] 谢斌[1] 顾红光[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所肝胆外科,重庆400042

出　　处：《重庆医学》2010年第24期3386-3387,共2页Chongqing medicine

摘　　要：目的探讨胰腺体尾部癌的早期诊断和手术治疗效果。方法回顾性研究2001年1月至2008年12月治疗的28例胰体尾部癌患者的临床资料。结果本组病例中,实体癌22例,囊腺癌6例。CA19-9阳性率90%;血糖增高89.3%。PET检查6例未发现远处转移,但3～6个月后均发现转移。行胰腺体尾部根治性切除5例,姑息切除18例。囊肿空肠吻合或胃空肠吻合手术7例。实体癌患者总中位生存期为7个月,根治性切除组11个月,姑息性切除组4.5个月。6例囊腺癌患者中位生存期为23个月。结论胰腺体尾癌早期诊断困难,CA19-9、血糖检查有参考价值,PET对早期诊断有意义,但不能预测预后;胰腺体尾部切除治疗效果不能令人满意;囊腺癌的远期疗效明显好于实体肿瘤。Objective To explore the early diagonosis and surgical treatment of carcinoma of body and tail of pancreas.Methods The clinical data of 28 patients with carcinoma of body and tail of pancreas from January,2001 to December,2008 was retrospectively analyzed.Results All cases were composed of 22 solid carcinoma and 6 cystadenocarcinoma.The positive expression of CA19-9 was 90%.The rate of patients with high blood sugar was 89.3%.6 patients underwent PET without distant metastasis,but detected metastasis after 3～6 months.21 patients received body and tail of pancreas resection,5 of which was radical resection,16 was palliative resection.7 underwent gastrojejunostomy or cyst-jejunum anastomosis.The median survival period was 7 months for patients with solid carcinoma of body and tail of pancreas,11 months for the radical resection group,4.5 months for the palliative resectin,and 23 months for patients with cystadenocarcinoma of pancreas.Conclusion It is difficult to make a diagnosis in the early stage of carcinoma of body and tail of pancreas.the analysis of CA19-9 expression and blood glucose level was valuble for the detection of carcinoma of body and tail of pancreas.PET was valuable for early diagnosis but not useful for predicting the prognosis.The operative efficacy of body and tail of pancreas was not satisfactory.Long-time curative effect of cystadenocarcinoma of pancreas was better than that of solid carcinoma of body and tail of pancreas.

关 键 词：胰腺肿瘤 诊断 治疗 

分 类 号：R735.9[医药卫生—肿瘤] R730.56[医药卫生—临床医学]