Lee Jae Hoon, Lee Kyeong Geun, Ryou Hyunchul, Jun Young Jin, Paik Seung Sam, Park Hwon Kyum, Lee Kwang Soo
Department of Surgery, College of Medicine, Hanyang University, 17 Haengdang-dong, Seongdong-gu, Seoul 133-791, Korea.
Hepatogastroenterology. 2010 May-Jun;57(99-100):646-52.
BACKGROUND/AIMS: Periampullary adenocarcinoma has either intestinal- or pancreatobiliary-type of differentiation. These types and perineural invasion have been shown to have prognostic relevance. The influences of histologic type and perineural invasion on recurrence and survival in ampullar of Vater carcinoma still need to be assessed.
We reviewed and analyzed the clinicopathologic data, surgical outcomes, recurrence and survival of 49 patients who received curative pancreatoduodenectomy for ampulla of Vater carcinoma at Hanyang University Hospital between July 1994 and June 2008.
Twenty patients experienced recurrence, and the 5-year overall survival rates were 53.1%. Perineural invasion as well as tumor grade, T stage, lymph node metastasis, and lymphatic invasion were associated with survival (p < 0.05). The group positive for perineural invasion had a high recurrence rate (56.5% versus 28.0%) and a low 5-year survival (39.1% versus 68.0%) compared to those of the negative group. Pancreatobililary-type had a higher recurrence rate (58.3% versus 36.1%) and a lower 5-year survival rate (33.3% versus 61.1%) in comparison to intestinal-type. However, histologic type was not a statistically significant factor (p > 0.1).
Perineural invasion is a significant factor for survival. Histologic type has no significance as a prognostic factor despite differences between the two subgroups.
背景/目的：壶腹周围腺癌具有肠型或胰胆管型分化。这些类型以及神经周围浸润已被证明与预后相关。仍需评估组织学类型和神经周围浸润对 Vater 壶腹癌复发和生存的影响。
我们回顾并分析了 1994 年 7 月至 2008 年 6 月在汉阳大学医院接受根治性胰十二指肠切除术治疗 Vater 壶腹癌的 49 例患者的临床病理数据、手术结果、复发情况和生存情况。
20 例患者出现复发，5 年总生存率为 53.1%。神经周围浸润以及肿瘤分级、T 分期、淋巴结转移和淋巴管浸润与生存相关（p < 0.05）。与神经周围浸润阴性组相比，阳性组复发率高（56.5% 对 28.0%），5 年生存率低（39.1% 对 68.0%）。与肠型相比，胰胆管型复发率更高（58.3% 对 36.1%），5 年生存率更低（33.3% 对 61.1%）。然而，组织学类型不是一个具有统计学意义的因素（p > 0.1）。
神经周围浸润是生存的重要因素。尽管两个亚组之间存在差异，但组织学类型作为预后因素并无意义。
