CAJ | 학술논문

目的总结原发性胰腺淋巴瘤的诊治经验.方法回顾性分析2002年10月至2006年8月间复旦大学附属华山医院收治的8例原发性胰腺淋巴瘤病人资料.结果病灶位于胰头部7例,胰体尾部1例.临床表现包括上腹痛、上腹压痛、纳差、呕吐、黄疸、腰背痛、上腹肿块、发热、体重减轻等.5例合并胰胆管扩张,其中4例血清CA19-9轻度升高,其余肿瘤指标均处于正常范围.3例行血β2-微球蛋白及乳酸脱氢酶检查,均显示升高.1例行Whipple术,并行CHOP方案与美罗华化疗;2例直接行CHOP方案与美罗华化疗;4例行姑息性肿瘤切除,其中2例术后行CHOP方案与美罗华化疗,1例仅行美罗华化疗,另1例未行化疗;1例仅行剖腹探查病灶活检术.结论原发性胰腺淋巴瘤临床表现无特异性,辅助检查对诊断有提示作用,化疗为其主要的治疗手段,预后明显优于胰腺癌.
목적 총결원발성이선림파류적진치경험.방법 회고성분석2002년10월지2006년8월간복단대학부속화산의원수치적8례원발성이선림파류병인자료.결과 병조위우이두부7례,이체미부1례.림상표현포괄상복통、상복압통、납차、구토、황달、요배통、상복종괴、발열、체중감경등.5례합병이담관확장,기중4례혈청CA19-9경도승고,기여종류지표균처우정상범위.3례행혈β2-미구단백급유산탈경매검사,균현시승고.1례행Whipple술,병행CHOP방안여미라화화료;2례직접행CHOP방안여미라화화료;4례행고식성종류절제,기중2례술후행CHOP방안여미라화화료,1례부행미라화화료,령1례미행화료;1례부행부복탐사병조활검술.결론 원발성이선림파류림상표현무특이성,보조검사대진단유제시작용,화료위기주요적치료수단,예후명현우우이선암.
Objective To summarize the experience in diagnosis and treatment of primary pan-creatic lymphoma. Methods The clinical data of 8 patients with primary pancreatic lymphoma treatedin our hospital from October 2002 to August 2006 were retrospectively analyzed. Results Seven tumors were located in the head of pancreas and 1 in the body and tail of pancreas. Clinical manifesta-tions included epigastric pain,epigastric tenderness,nausea and vomiting,jaundice,back pain,epigastric mass,fever,loss of weight etc. Five patients had dilatation of bile and pancreatic duct and 4 of them had slightly increase of CA19-9 in the serum while all other patients had normal level of tumor markers.Three patients had increase of β2-microglobulin and LDH in the serum. One patient underwent Whip-ple procedure,CHOP and Mabthera chemotherapy and 2 CHOP and Mabthera chemotherapy. Four patients received tumor resection and palliative operation. For these 4 patients,2 received CHOP and Mabthera chemotherapy and 1 Mabthera chemotherapy. Biopsy was performed in only 1 patient. Con-clusion The symptoms of primary pancreatic lymphoma are not specific. Its auxiliary examination can provide important information for diagnosis. Chemotherapy is the main treating tool and its prognosis is obviously superior to pancreatic cancer.