中华胰腺病杂志
中華胰腺病雜誌
중화이선병잡지
CHINESE JOURNAL OF PANCREATOLOGY
2010年
1期
9-13
,共5页
胰腺%导管内乳头状黏液性肿瘤%症状和体征%放射学%外科治疗
胰腺%導管內乳頭狀黏液性腫瘤%癥狀和體徵%放射學%外科治療
이선%도관내유두상점액성종류%증상화체정%방사학%외과치료
Pancreas%Intraductal papillary mucinous tumors%Symptoms and signs%Radiology%Surgical therapy
目的 总结不同病理类型胰腺导管内黏液性乳头状瘤(IPMT)的临床表现,提高对IPMT的诊治水平.方法 回顾分析1996年3月至2008年9月间经手术切除且病理证实的49例IPMT患者的临床表现、影像学特点及病理学特征,比较分析良性、交界性、恶性IPMT的临床表现.结果 49例IPMT患者中男27例,女22例,平均年龄(58±11)岁.良性19例,交界性9例,恶性21例.3类IPMT患者在性别、发病年龄、烟酒史、胰腺炎发作史、糖尿病病史,是否存在腹痛、腰背部放射痛、腹胀、腹泻、消瘦等症状,血CEA、AST、ALT水平,肿瘤位置及肿瘤分型上的差异均无明显统计学意义.但黄疸、术前CA19-9和碱性磷酸酶水平、肿瘤直径、主胰管直径、囊性肿瘤内是否存在隔膜、附壁结节的大小等方面的差异有统计学意义.恶性IPMT术后5年有1例病死,1例复发;交界性和良性IPMT有1例复发,1例因其他疾病病死.结论 不同病理类型的IPMT 临床特征存在一些差异,需综合判断进行鉴别.
目的 總結不同病理類型胰腺導管內黏液性乳頭狀瘤(IPMT)的臨床錶現,提高對IPMT的診治水平.方法 迴顧分析1996年3月至2008年9月間經手術切除且病理證實的49例IPMT患者的臨床錶現、影像學特點及病理學特徵,比較分析良性、交界性、噁性IPMT的臨床錶現.結果 49例IPMT患者中男27例,女22例,平均年齡(58±11)歲.良性19例,交界性9例,噁性21例.3類IPMT患者在性彆、髮病年齡、煙酒史、胰腺炎髮作史、糖尿病病史,是否存在腹痛、腰揹部放射痛、腹脹、腹瀉、消瘦等癥狀,血CEA、AST、ALT水平,腫瘤位置及腫瘤分型上的差異均無明顯統計學意義.但黃疸、術前CA19-9和堿性燐痠酶水平、腫瘤直徑、主胰管直徑、囊性腫瘤內是否存在隔膜、附壁結節的大小等方麵的差異有統計學意義.噁性IPMT術後5年有1例病死,1例複髮;交界性和良性IPMT有1例複髮,1例因其他疾病病死.結論 不同病理類型的IPMT 臨床特徵存在一些差異,需綜閤判斷進行鑒彆.
목적 총결불동병리류형이선도관내점액성유두상류(IPMT)적림상표현,제고대IPMT적진치수평.방법 회고분석1996년3월지2008년9월간경수술절제차병리증실적49례IPMT환자적림상표현、영상학특점급병이학특정,비교분석량성、교계성、악성IPMT적림상표현.결과 49례IPMT환자중남27례,녀22례,평균년령(58±11)세.량성19례,교계성9례,악성21례.3류IPMT환자재성별、발병년령、연주사、이선염발작사、당뇨병병사,시부존재복통、요배부방사통、복창、복사、소수등증상,혈CEA、AST、ALT수평,종류위치급종류분형상적차이균무명현통계학의의.단황달、술전CA19-9화감성린산매수평、종류직경、주이관직경、낭성종류내시부존재격막、부벽결절적대소등방면적차이유통계학의의.악성IPMT술후5년유1례병사,1례복발;교계성화량성IPMT유1례복발,1례인기타질병병사.결론 불동병리류형적IPMT 림상특정존재일사차이,수종합판단진행감별.
Objective To summarize the clinical features of intraductal papillary mucinous tumors (IPMT) of the pancreas to improve the diagnosis and treatment of IPMT.Methods The clinical features,imaging features and clinicopatholagic characteristics of 49 IPMT patients,who underwent operations in our department from March 1996 to September 2008,were retrospectively analyzed.The clinical features of benign,borderline and malignant IPMT were compared.Results Among the 49 patients,there were 27 males and 22 females;the average age was 58±11 years.There were 18 benign cases,9 borderline cases and 22 malignant ones.The difference in sex ratio,age of disease onset,smoking and drinking habit,history of pancreatitis and diabetes,presence of abdominal pain,radiation pain,abdominal bloating and weight loss symptoms,serum levels of CEA,AST,ALT,tumor location and type were not significantly different between the 3 groups.However,there were significant difference in term of jaundice,serum carbohydrate antigen 19-9(CA19-9)and alkaline phosphatase (AKP) levels,size of tumor,diameter of main pancreatic duct,presence of septum in cystic tumor,mural modules in the tumor.Among the malignant IPMT patients,one patient died 5 years after operation,one patient had malignancy recurrence;among the benign and borderline IPMT patients,1 patient had malignancy recurrence and 1 patient died due to other disease.Conclusions Different types of IPMT had different clinical features and comprehensive judgment were needed to differentiate.
