中华胰腺病杂志
中華胰腺病雜誌
중화이선병잡지
CHINESE JOURNAL OF PANCREATOLOGY
2012年
6期
371-374
,共4页
王雷%夏天%廖专%邹多武%金震东%杜奕奇%湛先保%胡先贵%金钢%邵成浩%郑建明%王莉%李兆申
王雷%夏天%廖專%鄒多武%金震東%杜奕奇%湛先保%鬍先貴%金鋼%邵成浩%鄭建明%王莉%李兆申
왕뢰%하천%료전%추다무%금진동%두혁기%담선보%호선귀%금강%소성호%정건명%왕리%리조신
胰腺%乳头状黏液性肿瘤%诊断%治疗
胰腺%乳頭狀黏液性腫瘤%診斷%治療
이선%유두상점액성종류%진단%치료
Pancreas%Intraductal papillary mucinous neoplasm%Diagnosis%Therapy
目的 分析胰管内乳头状黏液性肿瘤(IPMN)的临床特征,以提高对该病的认识.方法 采用单中心回顾性研究方法,分析长海医院1993年1月至2012年8月间收治的361例IPMN的临床资料,分析其临床特征.结果 361例IPMN中,男性261例,女性100例,男女比例为2.6∶1,平均年龄61岁(16 ～87岁).其中主胰管型102例(28.3％),分支胰管型109例(30.2％),混合型150例(41.6％).患者的症状主要为急性胰腺炎发作,共167例(46.3％).内镜下胰胆管造影术(ERCP)的诊断符合率最高,为80.2％(130/162),MRCP、CT、内镜超声(EUS)的检查阳性率分别为76.9％(160/208)、63.9％(159/249)、50.5％(53/105).手术治疗129例,病理诊断为腺瘤87例(67.2％),交界性21例(16.4％),浸润性癌11例(8.2％),原位癌10例(8.2％).腺瘤及交界性IPMN患者的5年生存率为100％,恶性IPMN患者的5年生存率为66.5％,其中浸润性IPMN的5年生存率为44.7％.结论 IPMN以60岁左右高发,近一半患者表现为急性胰腺炎发作,且发作逐渐频繁,混合型IPMN比例最高,影像学检查阳性率并不高,手术治疗效果好.
目的 分析胰管內乳頭狀黏液性腫瘤(IPMN)的臨床特徵,以提高對該病的認識.方法 採用單中心迴顧性研究方法,分析長海醫院1993年1月至2012年8月間收治的361例IPMN的臨床資料,分析其臨床特徵.結果 361例IPMN中,男性261例,女性100例,男女比例為2.6∶1,平均年齡61歲(16 ～87歲).其中主胰管型102例(28.3％),分支胰管型109例(30.2％),混閤型150例(41.6％).患者的癥狀主要為急性胰腺炎髮作,共167例(46.3％).內鏡下胰膽管造影術(ERCP)的診斷符閤率最高,為80.2％(130/162),MRCP、CT、內鏡超聲(EUS)的檢查暘性率分彆為76.9％(160/208)、63.9％(159/249)、50.5％(53/105).手術治療129例,病理診斷為腺瘤87例(67.2％),交界性21例(16.4％),浸潤性癌11例(8.2％),原位癌10例(8.2％).腺瘤及交界性IPMN患者的5年生存率為100％,噁性IPMN患者的5年生存率為66.5％,其中浸潤性IPMN的5年生存率為44.7％.結論 IPMN以60歲左右高髮,近一半患者錶現為急性胰腺炎髮作,且髮作逐漸頻繁,混閤型IPMN比例最高,影像學檢查暘性率併不高,手術治療效果好.
목적 분석이관내유두상점액성종류(IPMN)적림상특정,이제고대해병적인식.방법 채용단중심회고성연구방법,분석장해의원1993년1월지2012년8월간수치적361례IPMN적림상자료,분석기림상특정.결과 361례IPMN중,남성261례,녀성100례,남녀비례위2.6∶1,평균년령61세(16 ～87세).기중주이관형102례(28.3％),분지이관형109례(30.2％),혼합형150례(41.6％).환자적증상주요위급성이선염발작,공167례(46.3％).내경하이담관조영술(ERCP)적진단부합솔최고,위80.2％(130/162),MRCP、CT、내경초성(EUS)적검사양성솔분별위76.9％(160/208)、63.9％(159/249)、50.5％(53/105).수술치료129례,병리진단위선류87례(67.2％),교계성21례(16.4％),침윤성암11례(8.2％),원위암10례(8.2％).선류급교계성IPMN환자적5년생존솔위100％,악성IPMN환자적5년생존솔위66.5％,기중침윤성IPMN적5년생존솔위44.7％.결론 IPMN이60세좌우고발,근일반환자표현위급성이선염발작,차발작축점빈번,혼합형IPMN비례최고,영상학검사양성솔병불고,수술치료효과호.
Objective To analyse the clinical characterization of intraductal papillary mucinous neoplasm of pancreas (IPMNs) and to improve the understanding of IPMNs.Methods Three hundred and sixty-one patients with IPMN at Shanghai Changhai Hospital between 1993 and 2012 were retrospectively analyzed.Results Among 361 cases of IPMNs,241 were men and 120 were female,with a female to male ratio of 2.6∶1.Mean age of the patients was 62 years old (16 ～ 87 years old).The duct type included the main duct in 102 patients (28.3％),a branch duct in 109 (30.2％),and mixed ducts in 150 (41.6％).The most common symptom at presentation is pancreatitis,which occur in 167 patients (46.3％).The sensitivity for the detection of IPMN was 80.2％ by ERCP,76.9％ by MRCP,63.9％ by CT,and 50.5％ by EUS.One hundred and twenty-nine patients (35.7％) were operated and diagnosed with 87 (67.2％) IPMA,21 (16.4％) IPMB,10(8.2％) IPMC(CIS) and 10 (8.2％) had invasive carcinomas.The 5-year survival rates of IPMA,IPMB,IPMC,and invasive carcinomas were 100％,100％,66.5％,and 44.7％,respectively.Conclusions IPMNs were fregrently occured is 60 years old,half of patients had acute pancreatitis history and the frequtly attack,mixed type is most anatomy type,and the outcome after surgery is good.
