Kakizaki K, Yamauchi H
Dept. of Surgery, Sendai National Hospital.
Gan To Kagaku Ryoho. 1991 Aug;18(11):2016-8.
A 66-year-old man was referred to our hospital with complaints of intractable abdominal and back pain, and diagnosed to have carcinoma of the pancreatic body. At laparotomy, he was assessed as unresectable because of cancer invasion of the superior mesenteric artery and abdominal aorta. Therefore two catheters connected to an implantable access device were placed in both the gastroduodenal and splenic arteries, in addition to gastrojejunostomy and chemical splanchnicectomy, followed by postoperative external irradiation therapy. The histological examination of the specimen obtained operatively confirmed that the lesion was moderately differentiated adenocarcinoma. Also the nuclear DNA analysis, carried out cytofluorometrically, showed diploid pattern. After discharge from our hospital, the man was treated by intra-arterial infusion chemotherapy in the outpatient department every two weeks. He lived a nearly normal life with satisfactory quality for two years until he died of GI-bleeding. In addition to the fact that the biological aggressiveness of the carcinoma cells assessed by DNA ploidy was relatively low, the combined modality therapy including pain control might benefit patients.
一名66岁男性因顽固性腹痛和背痛转诊至我院,被诊断为胰体癌。剖腹手术时,由于癌症侵犯肠系膜上动脉和腹主动脉,评估为不可切除。因此,除了胃空肠吻合术和化学性内脏神经切除术外,还在胃十二指肠动脉和脾动脉中放置了两根与植入式通路装置相连的导管,随后进行术后外照射治疗。手术获取标本的组织学检查证实病变为中分化腺癌。此外,通过细胞荧光测定法进行的核DNA分析显示为二倍体模式。该男子出院后,每两周在门诊接受一次动脉内灌注化疗。他过着几乎正常的生活,生活质量令人满意,持续了两年,直到死于消化道出血。除了通过DNA倍性评估的癌细胞生物学侵袭性相对较低这一事实外,包括疼痛控制在内的综合治疗模式可能对患者有益。