胰头癌的临床病理特点与根治术后预后的关系

目的　探讨胰头癌临床病理特点与根治术后预后的关系。方法　回顾分析 5 6例行胰头十二指肠切除术的胰头癌病人的临床病理特点 ,并用Kaplan Meier法、log rank法及秩和检验分析术后生存时间及生存时间之间的差异。结果　胰腺前方被膜及组织被肿瘤侵犯的 19例较未被侵犯的 37例、门静脉系被肿瘤侵犯的 18例较未被侵犯的 38例、淋巴结转移的 2 9例较无转移的 2 7例、腹膜种植转移的 3例较无种植转移的 5 3例、肝转移的 5例较无转移的 5 1例、远隔脏器转移 (包括腹膜种植转移和肝转移在内 )的 11例较无转移的 4 5例术后生存率均低 (P >0 0 5 )。而肿瘤大小 ,胰后面组织、胰内胆管、十二指肠壁、动脉系、胰腺外神经丛等被肿瘤侵犯与否与术后生存率均无关。结论　在胰头癌 ,淋巴结转移、腹膜种植转移及肝等远隔脏器转移、胰腺前方被膜及组织和门静脉系受侵可能是胰头十二指肠切除术后的预后决定因素。

Relationship between clinicopathological features of pancreatic head carcinoma and its prognosis after radical resection

Objective To explore the relationship between clinicopathological features of pancreatic head carcinoma (PHC) and its prognosis after pancreatoduodenectomy. Methods The clinicopathological features were retrospectively analyzed in 56 patients with PHC undergoing pancreatoduodenectomy in our hospital. Meanwhile,the survival time and difference in survival time of the patients after the operation were analyzed by Kaplan-Meier,log-rank test and rank sum test. Results The survival rate was significantly lower in 19 cases with anterior pancreatic capsular invasion than in 37 without,lower in 18 cases with portal venous system invasion than 38 without,lower in 29 cases with lymph node metastasis than in 27 without,lower in 3 cases with peritoneal metastasis than in 53 without,lower in 5 cases with liver metastasis than in 51 without and lower in 11 cases with distant metastasis than in 45 without (P<0.05). However,it was not associated with the size of tumor,retroperitoneal tissue invasion,distal bile duct invasion,duodenal wall invasion,arterial system invasion and peripancreatic nerve invasion. Conclusions Lymph node state,peritoneal metastasis,liver metastasis,other distant metastasis,anterior pancreatic capsular invasion and portal venous system invasion are definite factors influencing the prognosis of PHC after pancreatoduodenectomy.