胰腺肉瘤样癌的诊断与处理(附29例分析)  

Diagnosis and management of sarcomatoid carcinoma of the pancreas:with analysis of 29 cases

作　　者：乔盈盈 许艳 刘南斌 赵泽坤 陈泉宁[1] 施宝民[1] Qiao Yingying;Xu Yan;Liu Nanbin;Zhao Zekun;Chen Quanning;Shi Baomin(General Surgical Department,Tongji Hospital of Tongji University, Shanghai 200065, China)

机构地区：[1]同济大学附属同济医院普外科,上海200065

出　　处：《腹部外科》2020年第5期371-375,共5页Journal of Abdominal Surgery

摘　　要：目的探讨胰腺肉瘤样癌(pancreatic sarcomatoid carcinoma,PSC)的临床特点、诊断、治疗手段。方法检索查找中英文文献,共搜集文献报道PSC 28例,加上同济大学附属同济医院2年前确诊的1例PSC,共对29例PSC病人进行回顾性分析。结果PSC多见于50岁以上病人,男性多发于女性(男女比例约2.6∶1),86%因左上腹持续性疼痛入院。CT检查96%可见低密度肿块,轻度不均匀强化;半数以上CA19-9高于正常值;肉瘤样组织免疫组化可见上皮性和间叶性标志物。治疗以根治性手术为主,化疗多采用吉西他滨联合其他药物的方法。疾病进展快,预后差。结论PSC诊断主要依靠CT筛查和病理检查确诊,手术仍为首选治疗方法。Objective To explore the clinical characteristics,diagnosis and treatment of pancreatic sarcomatoid carcinoma.Methods A total of 29 cases were retrospectively analyzed including 28 cases from searching literature and 1 case diagnosed in our hospital two years ago.Results Sarcomatoid carcinoma of the pancreas was more common in people over 50 years old,and more common in the male than the female(the ratio of male to female was about 2.6∶1),86%were admitted for persistent pain in the left upper quadrant.CT examination revealed 96%with low-density masses and mild uneven enhancement.CA19-9 is higher than normal(>50%cases);epithelial and mesenchymal markers are both positive in the immunochemistry of tumor tissue.Radical surgery is still main treatment,and gemcitabine combined with other drugs is widely used in chemotherapeutic treatment.The disease progresses rapidly with poor prognosis is poor.Conclusion Diagnosis of Pancreatic sarcomatoid carcinoma mainly depends on CT screening and pathological examination,and surgery is still the preferred treatment.

关 键 词：消化道肿瘤 肉瘤样癌 胰腺恶性肿瘤 

分 类 号：R604[医药卫生—外科学]