CAJ | 학술논문

目的探讨原发性胰腺小细胞癌的临床病理特点、治疗及预后情况.方法联机检索中国期刊全文数据库、维普中文科技期刊数据库、Medline/Pubmed及OVID全文数据库,检索截止至2012年4月,并结合南京鼓楼医院诊治的1例患者,进行系统评价.结果纳入28篇文献46例诊断明确的病例,加上鼓楼医院1例,共47例胰腺小细胞癌患者.该病以男性多见,中位年龄62岁,临床表现以腹痛、黄疸及消瘦为主,较少产生副肿瘤综合征；多见血清神经元特异性烯醇化酶升高；CT检查示病灶多呈不均匀强化,确诊依靠病理检查；63.8％( 30/47)的患者确诊时已发生转移,患者总的中位生存期为28周.目前无统一治疗模式,推荐以化疗为主的系统治疗.结论胰腺小细胞癌是一种发生率低、恶性程度高、侵袭性强、预后差的神经内分泌肿瘤.
목적 탐토원발성이선소세포암적림상병리특점、치료급예후정황.방법 련궤검색중국기간전문수거고、유보중문과기기간수거고、Medline/Pubmed급OVID전문수거고,검색절지지2012년4월,병결합남경고루의원진치적1례환자,진행계통평개.결과 납입28편문헌46례진단명학적병례,가상고루의원1례,공47례이선소세포암환자.해병이남성다견,중위년령62세,림상표현이복통、황달급소수위주,교소산생부종류종합정；다견혈청신경원특이성희순화매승고；CT검사시병조다정불균균강화,학진의고병리검사；63.8％( 30/47)적환자학진시이발생전이,환자총적중위생존기위28주.목전무통일치료모식,추천이화료위주적계통치료.결론 이선소세포암시일충발생솔저、악성정도고、침습성강、예후차적신경내분비종류.
Objective To investigate the clinicopathologic features,therapy,and prognosis of primary small cell carcinoma of the pancreas.Methods Databases including Chinese Journal Full-text Database,VIP Database for Chinese Technical Periodicals,Medline/Pubmed,and OVID were searched electronically up to April 2012.A systematic review was performed together with one case in our hospital.Results Twenty-eight articles fulfilling the criteria consisting of 46 patients with pathologically confirmed diagnosis of primary small cell carcinoma of the pancreas were studied,together with 1 patient in our Drum Tower Hospital,finally 47patients were included.The results of this systematic review showed:( 1 ) Primary small cell carcinoma of the pancreas was more common in men with a median age of 62.The most common clinical presentations were abdominal pain,jaundice and weight loss.Para-neoplastic syndrome was rarely observed.(2)Most cases were found to have abnormally elevated serum levels of neuron-specific enolase.CT displayed heterogeneous,and marked enhancing masses in most cases.The conclusive diagnosis depended on histological confirmation.(3)63.8％ of the cases were found to be associated with metastasis at the time of diagnosis.The overall median survival time was 28 weeks.(4) There was no consensus on the treatment of primary small cell carcinoma of the pancreas. Chemotherapy was currently considered as the treatment of choice among the systematic management for these patients.Conclusions Primary small cell carcinoma of the pancreas was a rare and aggressive neuroendocrine tumor with a poor prognosis.