Ishikawa O, Ohhigashi H, Wada A, Tateishi R, Ishiguro S, Okano Y, Sasaki Y, Imaoka S, Koyama H, Iwanaga T
Department of Surgery, Center for Adult Diseases, Osaka, Japan.
Cancer. 1989 Sep 1;64(5):1107-12. doi: 10.1002/1097-0142(19890901)64:5<1107::aid-cncr2820640523>3.0.co;2-y.
For 81 cases of resectable pancreatic carcinoma, the site of cancer origin, cancer histologic features, and hyperplasia in the noninvolved duct were studied in relation to diabetes. They were classified into the following three groups: (1) fasting blood sugar (FBS) of less than 120 mg/dl (Group A, 26 cases); (2) FBS of more than 120 mg/dl with less than 2-year history of diabetes (Group B, 38 cases); and (3) FBS of more than 120 mg/dl with more than a 2-year history of diabetes (Group C, 17 cases). Although neither tumor size nor tumor location differed between the three groups, both the highest resectability (47%) and the lowest rate (71%) of extrapancreatic invasion were seen in Group C. A pancreatic ductogram showed that the pattern of the main pancreatic duct was intact in 0% in Group C versus 35% in Group A (P less than 0.05). Histologically, papillary/well-differentiated adenocarcinoma was present in 35% of Group A patients versus 61% of Group B and 71% of Group C patients (P less than 0.05). Papillary hyperplasia was present in the ducts of 27% of the patients in Group A; this was significantly lower than the other two groups. Atypical duct hyperplasia was present in 47% of Group C patients; this was significantly higher than in the other two groups. It appears that cells in the main pancreatic duct are vulnerable to hyperplastic and well-differentiated cancerous changes in patients with a history of diabetes of more than 2 years duration.
对于81例可切除胰腺癌患者，研究了癌起源部位、癌组织学特征以及未受累导管的增生情况与糖尿病的关系。他们被分为以下三组：（1）空腹血糖（FBS）低于120mg/dl（A组，26例）；（2）FBS高于120mg/dl且糖尿病病史少于2年（B组，38例）；（3）FBS高于120mg/dl且糖尿病病史超过2年（C组，17例）。尽管三组之间肿瘤大小和肿瘤位置均无差异，但C组的可切除率最高（47%），胰腺外侵犯率最低（71%）。胰管造影显示，C组主胰管形态完整的比例为0%，而A组为35%（P<0.05）。组织学上，A组35%的患者存在乳头/高分化腺癌，而B组为61%，C组为71%（P<0.05）。A组27%的患者导管存在乳头增生；这一比例显著低于其他两组。C组47%的患者存在非典型导管增生；这一比例显著高于其他两组。似乎糖尿病病史超过2年的患者，主胰管细胞易发生增生性和高分化癌性改变。
