Wu Tie-cheng, Shao Yong-fu, Shan Yi, Wu Jian-xiong, Zhao Ping
Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Science, Beijing 100021, China.
Zhonghua Wai Ke Za Zhi. 2007 Jan 1;45(1):30-3.
To investigate the clinical-pathological characteristics and surgical prognosis of malignant tumor of pancreatic body and tail.
A retrospective study was accomplished on clinical manifestation, pathological behavior and postoperative survival in 106 patients with malignant tumor of pancreatic body and tail in single institution from Jan 1980 to Dec 2003, and compared these with 451 patients with malignant pancreatic cancer.
There were significant differences in the following parameters (malignant tumor of the body and tail vs those of the head) between the two tumors: (1) the complaints of pain (0.74:41, chi(2) = 37.035, P < 0.01) and jaundice (0.04:0.75, chi(2) = 155.509, P < 0.01); (2) serum SGPT [(27.33 +/- 3.98) U/L: (118.60 +/- 4.59) U/L, F = 89.351, P < 0.01], total bilirubin [(1.46 +/- 0.46) mg/dl: (14.11 +/- 0.60) mg/dl, F = 105.341, P < 0.01] and albumin [(4.20 +/- 0.45) g/L: (3.91 +/- 0.03) g/L, F = 26.642, P < 0.001]; (3) CEA (0.40:0.24, chi(2) = 6.148, P = 0.046) and CA-19-9 positive rate (0.57:0.86, chi(2) = 24.132, P < 0.01); (4) the concomitant total metastasis (0.38:0.20, chi(2) = 14.266, P < 0.01), including liver metastasis (0.30:0.17, chi(2) = 9.003, P < 0.01). Postoperative median survival, resection of non-metastatic pancreatic body and tail cancer was longer than resection of metastatic disease significantly (15 vs 7 months,chi(2) = 21.63, P < 0.01), which the latter was the same as those who didn't remove (6 months,chi(2) = 0.22, P = 0.64).
The predominant problem is distant metastasis (especially liver metastasis) in the malignant tumor of the body and tail of the pancreas in comparison with pancreatic head cancer. Resection of the body and tail could not increase postoperative survival if metastasis exists. The major way to improve the prognosis is to prevent and manage the distant metastasis.
探讨胰体尾恶性肿瘤的临床病理特征及手术预后。
对1980年1月至2003年12月在单一机构就诊的106例胰体尾恶性肿瘤患者的临床表现、病理行为及术后生存情况进行回顾性研究，并与451例胰腺癌患者进行比较。
两种肿瘤在以下参数方面存在显著差异（胰体尾恶性肿瘤与胰头恶性肿瘤相比）：（1）疼痛主诉（0.74:41，χ² = 37.035，P < 0.01）和黄疸（0.04:0.75，χ² = 155.509，P < 0.01）；（2）血清谷丙转氨酶[（27.33 ± 3.98）U/L:（118.60 ± 4.59）U/L，F = 89.351，P < 0.01]、总胆红素[（1.46 ± 0.46）mg/dl:（14.11 ± 0.60）mg/dl，F = 105.341，P < 0.01]和白蛋白[（4.20 ± 0.45）g/L:（3.91 ± 0.03）g/L，F = 26.642，P < 0.001]；（3）癌胚抗原（0.40:0.24，χ² = 6.148，P = 0.0）和糖类抗原19-9阳性率（0.57:0.86，χ² = 24.132，P < 0.01）；（4）合并全身转移（0.38:0.20，χ² = 14.266，P < 0.01），包括肝转移（0.30:0.17，χ² = 9.003，P < 0.01）。非转移性胰体尾癌切除术后的中位生存期明显长于转移性疾病切除术（15个月对7个月，χ² = 21.63，P < 0.01），后者与未切除者相同（6个月，χ² = 0.22，P = 0.64）。
与胰腺癌相比，胰体尾恶性肿瘤的主要问题是远处转移（尤其是肝转移）。如果存在转移，切除胰体尾并不能提高术后生存率。改善预后的主要方法是预防和处理远处转移。
