胰头癌63例临床病理分析

目的:探讨接受外科治疗的胰头癌患者的临床病理特点。方法:回顾性将根治性切除与姑息性切除手术病例进行对照,对其年龄、性别、症状、体征、围手术期情况、肿瘤标记物检查、临床病理、手术并发症、手术切除率、生存率及其影响因素进行分析。结果:63例中,52例(91.2%)获得随访,根治组中位生存时间(13.8个月)明显高于姑息组(6.2个月)(P0.05),姑息组(6.2个月)与非手术组(5.4个月)无明显差异(P0.05);根治组患者导管腺癌发生率与姑息组比较有显著差异(P0.05);T1期患者切除率高于T4期(P0.01),CA19-9数值与胰头癌可切除率无明显相关(P0.05)。结论:手术是提高胰头癌患者生存率的重要手段,具有不同临床分期的胰头癌病人手术切除率及术后生存期具有显著差异。CA19-9可作为胰头癌常规的筛查方法,但与疾病进展程度无关。

Clinical Pathologic Analysis of 63 Cases of Carcinoma of Head of Pancreas

Objective To explore the clinicopathological characteristics of operated patients withc arcinoma of head of pancreas.Methods Retrospective studies were done on radical resection and palliativer esection cases for comparison on their age,sex,symptoms,signs,perioperative situation,tumor markere xamination,clinical pathology,and surgical complications.And the surgical resection rate,the postoperatives urvival and the influencing factors were analyzed.Fifty-two cases were followed-up.Results The survivalt ime of surgical radical resection group was significantly higher than that of palliative group（P〈0.05）.Therew as no difference on survival time between palliative group and non-operative group（P〈0.05）.T1 curative ratew as higher than that in patients with T4 period（P〈0.01）,the curative rate of phase I was higher than that ofp hase IV,CA19-9 value and the resectability of pancreatic head cancer showed no significant correlation（P〈0.05）.CA19-9 was not related to the curative rate.Conclusions Surgery is the primary treatment to improvet he survival rate of carcinoma of head of pancreas.With different clinical stages,there are significant differenceso n curative rate and postoperative survival.For patients with carcinoma of head of pancreas CA19-9 can beu sed as a routine screening method,but has no relation to the extent of disease progression.