基于《欧洲胰腺囊性肿瘤循证指南》胰腺黏液性囊性肿瘤的影像学检查特征及影响肿瘤性质的因素分析  

Imaging features of pancreatic mucinous cystic neoplasms based on the European evidencebased guidelines on pancreatic cystic neoplasms and influencing factors of tumor preperty

作　　者：张茜茹 方旭 边云 王莉 邵成伟 陆建平 Zhang Qianru;Fang Xu;Bian Yun;Wang Li;Shao Chengwei;Lu Jianping(Department of Radiology,the First Affiliated Hospital of Naval Medical University(Changhai Hospital of Shanghai),Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院(上海长海医院)影像医学科,上海200433

出　　处：《中华消化外科杂志》2022年第12期1593-1599,共7页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金(81871352、82171915、82171930);上海市科技创新行动计划自然科学基金(21ZR1478500、21Y11910300);上海申康医院发展中心重大临床研究项目(SHDC2020CR4073);234学科攀峰计划平台学科夯基项目(2020YPT001)。

摘　　要：目的探讨基于2018版《欧洲胰腺囊性肿瘤循证指南》胰腺黏液性囊性肿瘤(MCN)的影像学检查特征及影响其肿瘤性质的危险因素。方法采用回顾性病例对照研究方法。收集2011年3月至2021年4月海军军医大学第一附属医院(上海长海医院)收治的109例MCN患者的临床病理资料;男5例、女104例,年龄为(49±15)岁。肿瘤性质为良性的患者97例,肿瘤性质为恶性的患者12例。观察指标:(1)不同肿瘤性质MCN患者的临床特征。(2)不同肿瘤性质MCN患者的影像学检查特征。(3)影响MCN患者肿瘤性质的多因素分析。正态分布的计量资料以x±s表示,组间比较采用t检验。偏态分布的计量资料以M(范围)表示,组间比较采用Mann‑Whitney U检验。计数资料以绝对数表示,组间比较采用χ^(2)检验或Fisher确切概率法。等级资料采用非参数秩和检验。将临床特征和影像学特征中有统计学意义的指标纳入多因素分析,多因素分析采用Logistic回归模型前进法。结果(1)不同肿瘤性质MCN患者的临床特征。97例良性MCN患者性别(男、女),年龄,体质量指数,临床症状(健康体检发现、腹痛腹胀、消瘦、黄疸、胰腺炎、新发糖尿病),CA19‑9(<37 U/mL、≥37 U/mL),癌胚抗原(<5.0μg/L、≥5.0μg/L),手术方式(胰十二指肠切除术、胰体尾切除术、胰腺节段切除术),囊肿部位(胰头部、胰体尾部)分别为4、93例,(47±14)岁,(22±3)kg/m2,56、35、2、1、11、5例,89、8例,96、1例,2、90、5例,4、93例;12例恶性MCN患者上述指标分别为1例,11例,(59±17)岁,(23±3)kg/m2,4、4、1、0、3、2例,5、7例,7、5例,0、12、0例,0、12例;两者年龄、CA19‑9、癌胚抗原比较,差异均有统计学意义(t=-2.69,χ^(2)=22.57、26.54,P<0.05);两者其余指标比较,差异均无统计学意义(P>0.05)。(2)不同肿瘤性质MCN患者的影像学检查特征。109例MCN患者中,85例行胰腺CT平扫和增强扫描检查,81例行胰腺磁共振成像(MRI)Objective To investigate the imaging features of pancreatic mucinous cystic tumor(MCN)based on the European evidence‐based guidelines on pancreatic cystic neoplasms and risk factors influencing tumor property.Methods The retrospective case-control study was conducted.The clinicopathological data of 109 pancreatic MCN patients who were admitted to the First Affiliated Hospital of Naval Medical University(Changhai Hospital of Shanghai)from March 2011 to April 2021 were collected.There were 5 males and 104 females,aged(49±15)years.There were 97 cases with benign tumors and 12 cases with malignant tumors.Observation indicators:(1)clinical characteristics of MCN patients with different tumor properties;(2)imaging features of MCN patients with different tumor properties;(3)multivariate analysis of factors affecting evaluating tumor properties of MCN.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was conducted using the t test.Measurement data with skewed distribution were represented as M(range),and comparison between groups was conducted using the Mann‐Whitney U test.Count data were described as absolute numbers,and comparison between groups was performed using the chi-square test or Fisher exact probability.Comparison of ordinal data was analyzed using the non-parameter rank sum test.Statistically significant indicators in clinical and imaging characteristics were included in multivariate analysis.Multivariate analysis was performed by the Logistic regression model forward method.Results(1)Clinical characteristics of MCN patients with different tumor properties.Gender(male,female),age,body mass index(BMI),cases with clinical symptoms(asymptomatically physical findings,abdominal pain and distension,emaciation,jaundice,pancreatitis,onset diabetes),cases with CA19‐9(<37 U/mL,≥37 U/mL),cases with carcinoembryonic antigen(<5.0μg/L,≥5.0μg/L),cases with surgical methods(pancreatoduodenectomy,pancreatectomy of body and tail,segmental pancreatectomy),cases wit

关 键 词：胰腺肿瘤 囊性肿瘤 黏液性 计算机断层扫描 磁共振成像 

分 类 号：R735.9[医药卫生—肿瘤]