胰腺癌疼痛与其临床病理学关系的探讨  

Relationship Between Pain and Clinicopathologic Factors of Resectable Pancreatic Cancer

作　　者：倪晓光[1] 赵平[1] 白晓枫[1] 

机构地区：[1]中国医学科学院,中国协和医科大学肿瘤医院腹部外科,100021

出　　处：《实用癌症杂志》2003年第4期414-416,共3页The Practical Journal of Cancer

基　　金：国家自然科学基金资助 (No .30 2 4 0 0 50 )

摘　　要：目的　探讨胰腺癌疼痛与临床病理学改变的相关性。方法　根据术前的疼痛情况将 3 8例手术的胰腺癌患者分为无疼痛组和疼痛组。疼痛组又分为单纯腹部疼痛组和腹部 +背部疼痛组。分析的病理学因素如下 :肿瘤的位置、肿瘤的大小、TNM分期、分化程度、淋巴结的转移、肿瘤的浸润。肿瘤的浸润包括动静脉系统、胰内、胰外神经、胰腺前方被膜、腹膜后组织、远端胆管、十二指肠壁等。结果　 3 8例手术切除胰腺癌的病例中 ,14例 (3 7% )术前无疼痛 ,2 4例 (63 % )术前有疼痛 ,其中单纯腹部疼痛 13例(3 4% ) ,腹部 +背部疼痛 11例 (2 9% )。在所分析的因素中 ,肿瘤的位置、肿瘤大小、肿瘤TNM分期以及肿瘤对动静脉系统、胰内神经、胰腺前方被膜、腹膜后组织的浸润与疼痛有显著相关性 (P <0 .0 5 ) ,而与肿瘤分化程度、淋巴结转移以及肿瘤对胰外神经、远端胆管和十二指肠壁的浸润无显著相关性 (P >0 .0 5 )。结论　疼痛与胰腺癌进展程度有显著相关性 。Objective To explore the relationship between pain and clinicopathologic factors of resectable pancreatic cancer.Methods 38 patients with resectable pancreatic cancer were classified into two groups:those without pain and those with pain before operation.The patients with pain were divided into two subgroups:those with only abdominal pain and those with abdominal pain and back pain.The investigated pathologic factors were as follows:location of the pancreatic cancer,size of pancreatic tumor,TNM staging,differentiated degree,lymph node metastasis,and tumor invasion.Results In the cases of 38 patients with resectable pancreatic cancer,14(37%) patients were free from pain,24(63%) patients had pain before the operation.13(34%) patients had only abdominal pain,11(29%) patients had abdominal pain and back pain.The location of pancreatic cancer,the size of pancreatic tumor,TNM staging and invasion of the venous/arterial system,intrapancreatic nerves,anterior pancreatic capsule,retroperitoneal tissue were significantly related to pain(P<0.05).The pain was not significantly related to differentiated degree,lymph node metastasis,and invasion of extrapancreatic nerve plexuses,distal bile duct,duodenal wall(P>0.05).Conclusion Abdominal and/or back pain are correlated with some malicious behaviors of pancreatic cancer.Back pain is related to the tumor progressive degree and indicates advanced disease.

关 键 词：胰腺癌 疼痛 临床病理学 肿瘤进展程度 

分 类 号：R735.9[医药卫生—肿瘤] R441.1[医药卫生—临床医学]