原发性胰腺癌的中医证型与增强CT影像表现的相关性研究  

Study on the correlation between the TCM syndrome types of primary pancreatic cancer and contrast-enhanced CT imaging findings

作　　者：任帅 钱丽超 汤汇涓 郭凯 王智涛 杨惠民[2] 王中秋 舒鹏 REN Shuai;QIAN Li-chao;TANG Hui-juan;GUO Kai;WANG Zhi-tao;YANG Hui-min;WANG Zhong-qiu;SHU Peng(Affiliated Hospital of Nanjing University of Chinese Medicine(Jiangsu Province Hospital of Chinese Medicine),Nanjing 210029,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]南京中医药大学附属医院(江苏省中医院),南京210029 [2]北京中医药大学东直门医院,北京100700 [3]南京中医药大学附属医院(江苏省中医院)放射科,210029

出　　处：《中华中医药杂志》2021年第9期5546-5549,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：江苏省研究生科研与实践创新计划项目(No.KYCX201477);国家自然科学基金面上项目(No.81771899);江苏省中医药局科技项目(No.ZD201907);国家留学基金委资助项目(No.201909077001);江苏省科技与社会发展重大项目(No.BE2017772);江苏省中医院高峰学术人才项目(No.y2018rc04)。

摘　　要：目的:分析原发性胰腺癌的中医证型与增强CT影像表现的相关性。方法:70例原发性胰腺癌患者均接受增强CT检查,同时收集患者的临床生化指标,并对不同证型患者的增强CT影像表现统计分析,探讨不同生化指标及增强CT影像表现与中医证型的相关性。结果:70例胰腺癌患者包括26例气滞血瘀型、21例肝胆湿热型及23例脾肾虚损型,3种证型对应的肿瘤大小差异存在统计学意义[(4.10±0.78)cm vs (3.70±0.74)cm vs(3.43±1.30)cm,P<0.05];与另外两型比较,气滞血瘀型患者CA19-9表达水平更高(P<0.05),且肿瘤呈囊实性及出现胰周侵犯的概率更高(P<0.05);病灶在胰实质期、门脉期的CT值与病灶/胰实质的CT比值比对于证型的鉴别诊断具有提示意义(P<0.05)。结论:CA19-9表达水平及增强CT影像表现能够对原发性胰腺癌的临床中医辨证提供客观化依据。Objective: To investigate the correlation between the TCM syndrome types of primary pancreatic cancer(PC)and contrast-enhanced CT(CE-CT) imaging findings. Methods: Seventy PC patients underwent CE-CT examinations. Clinical biochemical indicators were collected, and CE-CT imaging findings were retrospectively analyzed. The correlations between the TCM syndrome types of PC and different clinical biochemical indicators and CE-CT imaging findings were evaluated. Results:Seventy PC patients can be divided in to 26 case with qi stagnation and blood stasis type, 21 cases with liver and gallbladder damp-heat type, and 23 cases with spleen-kidney vacuity detriment type. There was a statistical significance of tumor size among the 3 TCM syndrome types [(4.10±0.78)cm vs(3.70±0.74)cm vs(3.43±1.30)cm,P<0.05];Qi stagnation and blood stasis type had a higher level of CA19-9 values and high frequencies of solid-cystic type and peripancreatic invasion compared to the other TCM syndrome types(P<0.05). CT attenuation values and mass-to-pancreas enhancement ratio at the pancreatic parenchymal and portal phases could help to differentiate different TCM syndrome types(P<0.05). Conclusion: CA19-9 levels and CE-CT imaging findings can provide objective basis for the clinical syndrome differentiation of primary PC.

关 键 词：原发性胰腺癌 中医证型 增强CT 影像表现 CA19-9 

分 类 号：R273[医药卫生—中西医结合]