胰腺腺鳞癌9例临床分析

目的：探讨胰腺腺鳞癌临床病理学特点和诊断治疗方法。方法：回顾性分析9例经手术和病理证实的胰腺腺鳞癌的临床、手术及病理资料。结果：本组共9例，77．8％（7／9）为老年患，肿瘤位于胰头6例，胰体尾3例。主要的临床表现是黄疸和腹痛，CT提示胰腺低密度占位。8例获手术切除，1例行胆囊空肠襻式吻合术。病理检查：瘤体平均直径为4．5cm，镜下表现为腺癌和鳞癌混杂。肿瘤侵犯十二指肠3例，侵犯肠系膜上静脉1例，侵犯脾静脉1例，侵犯胃1例，侵犯神经2例，淋巴结转移2例，肝转移1例。随访7例，术后生存3－17月，平均生存时间5．5月，均死于肿瘤复发和肝转移。结论：胰腺腺鳞癌呈侵袭性生长，易侵犯周围脏器和远处转移，恶性程度高，预后差；临床症状和影像学表现无特异性，术前确诊困难；手术切除是有效的治疗手段。

Clinical analysis of pancreatic adenosquamous carcinoma: A report of 9 cases

Objective To investigate the clinical features, diagnosis and treatment of pancreatic adenosquamous carcinoma. Methods A retrospective clinical analysis was made in 9 cases of pancreatic adenosquamous carcinoma. Results 77.8%(7/9)of patients with pancreatic adenosquamous carcinoma were up 60 years of age. Tumors in 6 patients were located in the head of the pancreas, and 3 patients in the body and tail. Tumors of 8 patients were surgically resected and 1 patient treated by cholecysto-duodenectomy. The pathological results of all patients revealed adenosquamous. 7 patients were followed up; the mean survival time was 5. 5 months after operation, all patients died of tumor recurrence and liver metastasis. Conclusions Pancreatic adenosquamous carcinoma demonstrates aggressive biological behavior. Invasion to adjoined organ and metastasis is the trend of the tumor. The prognosis of this admixed tumor appears to be even less favorable than the invasive ductal tumor.