上海市市区350例胰腺癌病理特征的初步分析

目的:初步分析上海市市区常住居民胰腺癌的病理特征。方法:2006年12月—2011年1月在上海市市区开展以人群为基础的大规模胰腺癌病例-对照研究,共收集387例病理切片,由上海市5名资深病理医师对所有病例的病理切片进行复查。根据WHO胰腺肿瘤组织学分类(2010年第4版)进行病理分型。结果:确诊胰腺癌350例(90.4%),病理标本以切除标本为主(311/350,88.9%)。胰腺肿瘤平均直径4cm,198例(56.6%)发生在胰头,组织学类型以导管腺癌最常见(311例,89.0%),其次为胰腺神经内分泌肿瘤15例(4.3%)。组织学分级以Ⅱ/Ⅲ级最多见(252例)。TNM分期:40例为ⅠA期,209例为ⅠB期和ⅡA期,80例为ⅡB期。明确神经侵犯者175例,有淋巴管和(或)静脉内癌栓者56例。病理复查仅发现1例误诊。结论:通过病理复查提高了对上海市市区胰腺癌病理特征的认识。

Pathologic characteristics of pancreatic cancer in Shanghai urban area:preliminary analysis of 350 cases

Objective:To investigate the pathologic characteristics and differential diagnosis of pancreatic cancer among residents in Shanghai urban area.Methods:A population-based large case-control study was performed in patients with pancreatic cancer between December 2006 and January 2011 in Shanghai urban area.The pathologic slides from 387 cases of pancreatic cancer were collected and reviewed by five experienced pathologists.The pathologic diagnosis was determined according to WHO Classification of Tumors of the Digestive System,Fourth Edition(2010).Results:Three hundred and fifty cases(90.4%) were confirmed as pancreatic cancer.Most of the pathologic slides were obtained from resected tissues of pancreatic cancer(311/350,88.9%).The average diameter of the tumor was 4 cm,and 56.6%(n = 198) of the tumors were located in the head of pancreas.The ductal adenocarcinoma was the most common histologic subtype(n = 311,89.0%),followed by pancreatic neuroendocrine tumors(n = 15,4.3%).The most common histologic grades were Ⅱ/Ⅲ(n = 252).According to TNM staging system,40 cases had stage ⅠA,209 cases had stages ⅠB/ⅡA,and 80 cases had stage ⅡB.The perineural invasion was identified in 175 cases,and the lymphovascular and/or venous emboli were identified in 56 cases.Only one case was misdiagnosed.Conclusion:The understanding of pathology of pancreatic cancer in Shanghai urban area was improved through this pathologic review.