胰腺癌133例临床诊治分析  

Strategies of diagnosis and surgical treatment for pancreatic cancer： A report of 133 cases

作　　者：韩非[1] 詹苏东[1] 章孟[1] 王春友[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院胰腺外科中心,武汉430022

出　　处：《腹部外科》2012年第2期95-96,共2页Journal of Abdominal Surgery

摘　　要：目的分析胰腺癌的临床特点，总结胰腺癌的诊治经验。方法对2006年1月至2006年12月收治的133例胰腺癌病人的临床资料进行回顾性分析。结果CT诊断106例（79．7％），MRI或磁共振胰胆管成像（MRCP）诊断53例（39．8％）；癌抗原（CA）19—9阳性107例（80．5％），CAl25阳性7（）例（52．6％），癌胚抗原（CEA）阳性65例（48．9％）。本组行手术治疗99例，包括胰十二指肠切除术46例，胰体尾切除术12例，^125I粒子植入＋姑息手术34例，其它7例；行保守治疗34例。手术病人均无围手术期死亡，所有病例随访6个月～2年，中位生存期分别为：手术切除肿瘤的胰头癌病人为31个月，手术切除肿瘤的胰体尾癌病人为18个月，^125I粒子植入＋姑息手术的病人为13个月，保守治疗的病人为5个月。结论胰腺癌的诊断主要依靠综合运用肿瘤标志物和影像学检查；应根据不同的病理类型采取不同的治疗方法。Objective To study the strategies of diagnosis and surgical treatment for pancreatic cancer. Methods The clinical data of 133 cases of pancreatic cancer from Jan. 2006 to Dec. 2006 were analyzed retrospectively. Results One hundred and six cases （79. 7 %） were diagnosed by CT scan, and 53 cases （39. 8 %） were diagnosed by MRI or MRCP. One hundred and seven cases （80. 5 %） were CA 19-9 positive, 70 cases （52. 6 %） were CA125 positive, and 65 cases （48. 9 %） were CEA positive. Thirty-four cases received conservative treatment, and 99 cases were subjected to surgical treatments,including 52 cases to pancreaticoduodenectomy, 12 cases to distal pancreatectomy,25 cases to 125 iodine seeds implantation ＋ palliative operation, and 7 cases to other operations. No perioperative deaths occurred. All patients were followed up for 1 to 3 years. Median survival in patients with pancreatic carcinoma of head receiving surgical resection was 31 months, in those with pancreatic carcinoma of body and tail receiving surgical resection was 18 months, in those receiving 125 iodine seeds implantation ＋ palliative operation was 13 months, and in those receiving conservative treatment was 5 months. Conclusion The diagnosis of pancreatic cancer relies mainly on the comprehensive use of tumor markers and radiographic examination. Treatments should be chosen according to different pathologic type.

关 键 词：胰腺肿瘤 诊断 外科手术 

分 类 号：R735.905[医药卫生—肿瘤]