CAJ | 학술논문

目的探讨胰腺腺泡细胞癌的组织学特点、生物学特征、治疗方法及预后.方法回顾性分析1999至2008年间收治的10例胰腺腺泡细胞癌患者的临床特点、影像学改变、病理学特征、治疗经过及随访资料.结果 10例胰腺腺泡细胞癌患者中男9例,女1例,平均年龄(62±8)岁.CT检查示肿瘤位于胰腺钩突部1例,胰头7例,胰体尾2例;肿瘤大小平均为4.5 cm ×4.7 cm;7例胆总管和肝内胆管明显扩张、胰管扩张;2例侵犯肠系膜上静脉.行胰头十二指肠切除术8例,其中3例合并扩大淋巴结清扫术,2例合并门静脉切除置换;2例行胰体尾+脾切除.病理检查示瘤体平均4.0 cm×3.3cm×3.4 cm;镜下见5例胰头肿瘤侵犯十二指肠,2例侵犯肠系膜上静脉;7例肿瘤侵犯神经;6例淋巴结转移.随访9例,1例失访.术后存活3～51个月,平均存活18个月,均死于肿瘤复发和转移.结论胰腺腺泡细胞癌是胰腺一个独立的高度恶性的类型,对放化疗可能都不敏感,其生物学特征有待进一步研究.
목적 탐토이선선포세포암적조직학특점、생물학특정、치료방법급예후.방법 회고성분석1999지2008년간수치적10례이선선포세포암환자적림상특점、영상학개변、병이학특정、치료경과급수방자료.결과 10례이선선포세포암환자중남9례,녀1례,평균년령(62±8)세.CT검사시종류위우이선구돌부1례,이두7례,이체미2례;종류대소평균위4.5 cm ×4.7 cm;7례담총관화간내담관명현확장、이관확장;2례침범장계막상정맥.행이두십이지장절제술8례,기중3례합병확대림파결청소술,2례합병문정맥절제치환;2례행이체미+비절제.병리검사시류체평균4.0 cm×3.3cm×3.4 cm;경하견5례이두종류침범십이지장,2례침범장계막상정맥;7례종류침범신경;6례림파결전이.수방9례,1례실방.술후존활3～51개월,평균존활18개월,균사우종류복발화전이.결론 이선선포세포암시이선일개독립적고도악성적류형,대방화료가능도불민감,기생물학특정유대진일보연구.
Objective To investigate the histological features,biological features,clinical treatment and prognosis of pancreatic acinar cell carcinoma.Methods A retrospective review of 10 patients with pancreatic acinar cell carcinoma treated in our hospital from 1999 to 2008 was conducted and the clinical features,imaging changes,pathologic feature,treatment course and follow-up data were collected.Results There were 9 men and 1 woman with a mean age of (62±8) years old.Tumors were located in the uncinate process in 1 patient,head of pancreas in 7,body and tail in 2.The median size of these tumors was 4.5 cm×4.7 cm;common bile duct and intrahepatic bile duct,pancreatic duct dilation was detected in 7 cases,and superior mesenteric vein was invaded in 2 cases.Of the 10 patients,8 received pancreaticoduodenectomy,among these 8 patients,3 had extended lymph node dissection,2 had portal vein resection and replacement;2received resection of pancreatic body and tail as well as splenectomy.Histologically,the size of these tumors were 4.0 cm×3.3 cm×3.4 cm.Macrescopically,duodenum was invaded in 5 patients,superior mesenteric vein was invaded in 2 patients and neural invasion was present in 7 cases.Lymph node metastasis was noted in 6 cases.Follow-up data was available in 9 patients and 1 patient was lost in follow-up.The survival ranged from 3 to 51 months with a median survival 18 months,and 9 patients died of tumor recurrence and metastasis after operation.Conclusions Pancreatic acinar cell carcinoma should be recognized as a distinct tumor entity and it may not be sensitive to radiotherapy or chemotherapy.The biological features of pancreatic acinar cell carcinoma should be investigated further.