胰腺外分泌功能与胰腺癌分期、肿瘤大小关系的临床研究

目的 研究胰腺外分泌功能与胰腺癌分期、肿瘤大小的关系.方法 采用NBT-PABA试验测定39例胰腺癌、46例CP患者和20名正常人胰腺外分泌功能,分析其与胰腺癌JPS局部进展度(T因子)及肿瘤大小(Ts)的关系.结果 正常人PABA排泄率平均为(78.9±15.9)%;CP患者平均为(58.6±19.3)%,其中轻、中、重度CP的PABA排泄率分别为(75.5±23.6)%、(57.9±21.5)%、(45.5±16.7)%;胰腺癌患者PABA排泄率平均为(47.6±18.3)%.其中,L3+T4期胰腺癌患者PABA排泄率为(42.2±21.7)%,显著低于Tl+T2期患者的(64.8±11.1)%(P<0.05);TS3+TS4患者PABA排泄率为(34.8±17.2)%,显著低于TS1+TS2患者的(55.6±23.5)%(P<0.05);胰头癌PABA排泄率为(42.5±16.4)%,显著低于胰体尾癌的(71.8±9.6)%(P<0.05);33例胰头癌中,主胰管狭窄患者的PABA排泄率为(54.2±14.1)%,显著高于胰管中断患者的(37.6±14.1)%(P<0.05).胰腺癌与中、重度CP的胰腺外分泌功能无显著差异.结论 胰头癌患者的胰腺外分泌功能减低的程度与胰腺癌分期、肿瘤大小及部位有一定相关性,其中胰管中断为影响判定的因素.胰腺外分泌功能不能鉴别胰腺癌与中、重度CP.

The relationship of pancreatic exocrine function with the staging and the size of tumor in the patients with pancreatic cancer

Objective To investigate the relationship of pancreatic exocrine function with the pancreatic cancer staging and the size of tumor. Methods N-benzoyl-tryrosyl para-aminobenzoic acid (NBT- PABA) test was used to measure the pancreatic exocrine function of 39 pancreatic cancer patients, 46 chronic pancreatitis patients and 20 normal subjects. In pancreatic cancer group, the relationship of pancreatic exocrine function with the size of tumor (TS) and JPS classification (T factor) was analysed. Results The rate of NBT-PABA excretion in normal subjects, chronic pancreatitis patients were (78.9±15.9)%, (58.6± 19.3)%, respectively; in mild, moderate, severe chronic pancreatitis patients, the values of NBT-PABA were (75.5±23.6)%, (57.9±21.5)%, (45.5±16.7)% ; respectively. The rate of NBT-PABA excretion in pancreatic cancer patients was (47.6±18.3)%, and the rate of NBT-PABA excretion in patients with T3+T4 stage was (42.2±21.70%, and was obviously less than (64.8±11.2)% of T1+T2 stage (P<0.05). Tthe rate of NBT-PABA excretion in patients with TS3+TS4 was (34.8±17.2)%, and was significantly lower than (55.6±23.5)% of TS1+TS2(P<0.05). The rate of NBT-PABA excretion in patients with pancreatic head cancer was (42.5±16.4)%, which was significantly lower than (71.8±9.6)% of the pancreatic body and tail (P<0.05). In the 33 patients with pancreatic head cancer, the rate of NBT-PABA excretion in patients with main pancreatic duct stricture was (54.2±14.1) %, which was significantly higher than (37.6± 14.1)% of patients with main pancreatic duct interruption (P<0.05). There was no significant difference in pancreatic exocrine function between pancreatic cancer and moderate or severe chronic pancreatitis.Conclusions The pancreatic exocrine function was related to the pancreatic cancer staging and the size of tumor to some degree,but it was affected by mass location,and it was also affected by degrees of the pancreatic duct obstruction. The pancreatic exocrine function can not be used to differentiate pancreatic cancer from moderate or severe chronic pancreatitis.