胰头癌侵犯前路与非前路神经通路的多层螺旋CT表现分析及生存比较研究  

Multislice spiral CT findings and survival comparison of anterior and non-anterior nerve pathways involved in pancreatic head carcinoma.

作　　者：平鸿坤 谭广 李卉[1] PING Hong-kun;TAN Guang;LI Hui(Department of Medical Imaging,the Sixth People's Hospital,Shanghai Jiao Tong University,Shanghai 200233,China.)

机构地区：[1]上海交通大学附属第六人民医院放射科,上海200233

出　　处：《临床和实验医学杂志》2022年第19期2122-2126,共5页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金项目(编号:81871324)。

摘　　要：目的比较胰头癌侵犯前路与非前路神经通路的多层螺旋CT表现及生存情况。方法回顾性分析2014年12月至2019年12月上海交通大学医附属第六人民医院93例胰头癌患者的术前多层螺旋CT图像,根据胰头癌侵犯不同神经通路分为A组(侵犯前路神经通路)和B组(侵犯胰丛1/胰丛2/肠系膜根部神经通路),分析两组胰头癌的多层螺旋CT特征(肿瘤大小、胆总管及主胰管扩张、十二指肠浸润),比较两组患者的生存预后。结果A组肿瘤大小(3.00±0.94)cm,B组为(3.00±0.92)cm。A组胆总管扩张比例55.81%,B组为比例58.00%。A组主胰管扩张比例76.74%,B组为74.00%。A组十二指肠侵犯率为60.57%,B组为48.00%。两组患者肿瘤大小(P=0.882)、胆总管(P=0.832)及主胰管(P=0.760)扩张、十二指肠浸润情况(P=0.229)比较差异均无统计学意义。A组患者的总生存期为304 d,明显短于B组(528 d),差异有统计学意义(P=0.001)。结论侵犯前路神经通路和侵犯胰丛1/胰丛2/肠系膜根部神经通路的胰头癌多层螺旋CT表现无显著差异,但侵犯前路神经通路的胰头癌患者总生存预后明显较差。Objective To compare MSCT findings and survival of pancreatic head carcinoma involving anterior and non-anterior neural pathways.Methods The preoperative multi-slice spiral CT images of 93 patients with pancreatic head cancer from December 2014 to December 2019 in the Sixth People's Hospital affiliated to Shanghai Jiaotong University Medical University were retrospectively analyzed.Anterior neural pathway and group B(invasion of pancreatic plexus 1/pancreatic plexus 2/mesenteric root nerve pathway),the multi-slice CT features(tumor size,common bile duct and main pancreatic duct dilatation,twelve Intestinal infiltration),the survival prognosis of the two groups was compared.Results The tumor size was(3.00±0.94)cm in group A and(3.00±0.92)cm in group B.The proportion of common bile duct dilatation in group A was 55.81%,and that in group B was 58.00%.The proportion of dilated main pancreatic duct was 76.74%in group A and 74.00%in group B.The duodenal invasion rate was 60.57%in group A and 48.00%in group B.There were no significant differences in tumor size(P=0.882),common bile duct(P=0.832)and main pancreatic duct(P=0.760)dilation,and duodenal infiltration(P=0.229)between the two groups.The overall survival of patients in group A was 304 days,which was significantly shorter than that in group B(528 days),the difference was statistically significant(P=0.001).Conclusion There was no statistically significant difference in MSCT imaging findings of pancreatic head cancer involving anterior nerve pathway and plexus pancreaticus capitalis 1/plexus pancreaticus capitalis 2/root of mesentery pathway,but the overall survival prognosis of patients with pancreatic head cancer involving anterior nerve pathway was significantly worse.

关 键 词：胰腺癌 侵犯 神经通路 多层螺旋CT 生存 

分 类 号：R735.9[医药卫生—肿瘤]