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胰沟癌

Pancreatic groove cancer.

作者信息

Ku Yuan-Hao, Chen Shih-Chin, Shyr Bor-Uei, Lee Rheun-Chuan, Shyr Yi-Ming, Wang Shin-E

机构信息

aDepartment of Surgery bDepartment of Radiology, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan.

出版信息

Medicine (Baltimore). 2017 Jan;96(2):e5640. doi: 10.1097/MD.0000000000005640.

DOI:10.1097/MD.0000000000005640
PMID:28079795
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5266157/
Abstract

Pancreatic groove cancer is very rare and can be indistinguishable from groove pancreatitis. This study is to clarify the characteristics, clinical features, managements, and survival outcomes of this rare tumor.Brief descriptions were made for each case of pancreatic groove cancer encountered at our institute. Individualized data of pancreatic groove cancer cases described in the literature were extracted and added to our database to expand the study sample size for a more complete analysis.A total of 33 patients with pancreatic groove cancer were included for analysis, including 4 cases from our institute. The median tumor size was 2.7 cm. The most common symptom was nausea or vomiting (89%), followed by jaundice (67%). Duodenal stenosis was noted by endoscopy in 96% of patients. The histopathological examination revealed well differentiated tumor in 43%. Perineural invasion was noted in 90%, and lymphovascular invasion and lymph node involvement in 83%. Overall 1-year survival rate was 93.3%, and 3- or 5-year survival rate was 62.2%, with a median survival of 11.0 months. Survival outcome for the well-differentiated tumors was better than those of the moderate/poorly differentiated ones.Early involvement of duodenum causing vomiting is often the initial presentation, but obstructive jaundice does not always happen until the disease progresses. Tumor differentiation is a prognostic factor for survival outcome. The possibility of pancreatic groove cancer should be carefully excluded before making the diagnosis of groove pancreatitis for any questionable case.

摘要

胰腺沟癌非常罕见,可能与沟部胰腺炎难以区分。本研究旨在阐明这种罕见肿瘤的特征、临床特点、治疗方法及生存结果。对我院遇到的每例胰腺沟癌病例进行简要描述。提取文献中描述的胰腺沟癌病例的个体化数据并添加到我们的数据库中,以扩大研究样本量,进行更全面的分析。

共纳入33例胰腺沟癌患者进行分析,其中4例来自我院。肿瘤中位大小为2.7厘米。最常见的症状是恶心或呕吐(89%),其次是黄疸(67%)。96%的患者经内镜检查发现十二指肠狭窄。组织病理学检查显示43%为高分化肿瘤。90%有神经侵犯,83%有脉管侵犯和淋巴结受累。总体1年生存率为93.3%,3年或5年生存率为62.2%,中位生存期为11.0个月。高分化肿瘤的生存结果优于中/低分化肿瘤。

十二指肠早期受累导致呕吐往往是首发表现,但梗阻性黄疸直到疾病进展时才会出现。肿瘤分化是生存结果的一个预后因素。对于任何可疑病例,在诊断沟部胰腺炎之前应仔细排除胰腺沟癌的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f18/5266157/1b74e74fc5c7/medi-96-e5640-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f18/5266157/eaf2b756c447/medi-96-e5640-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f18/5266157/1b74e74fc5c7/medi-96-e5640-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f18/5266157/eaf2b756c447/medi-96-e5640-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f18/5266157/1b74e74fc5c7/medi-96-e5640-g006.jpg

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引用本文的文献

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Pancreatic groove cancer with large cystic lesion.伴有大囊性病变的胰腺沟癌。
Clin J Gastroenterol. 2025 Feb;18(1):242-247. doi: 10.1007/s12328-024-02071-1. Epub 2024 Nov 29.
2
Conservative management of groove pancreatitis - A case report with literature review.沟部胰腺炎的保守治疗——一例报告并文献复习
Int J Surg Case Rep. 2023 Oct 26;112:108995. doi: 10.1016/j.ijscr.2023.108995.
3
Could it be groove pancreatitis? A frequently misdiagnosed condition with a surgical solution.这会是胰管炎吗?一种常被误诊的疾病,有外科治疗方法。

本文引用的文献

1
Well differentiation and intact Smad4 expression are specific features of groove pancreatic ductal adenocarcinomas.高分化和完整的Smad4表达是沟部胰腺导管腺癌的特异性特征。
Pancreas. 2015 Apr;44(3):394-400. doi: 10.1097/MPA.0000000000000260.
2
Groove pancreatitis vs groove pancreatic adenocarcinoma. Report of two cases and review of the literature.沟部胰腺炎与沟部胰腺腺癌。两例报告并文献复习
Acta Gastroenterol Latinoam. 2013 Sep;43(3):248-53.
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Pancreatic carcinoma masquerading as groove pancreatitis: case report and review of literature.
ANZ J Surg. 2022 Sep;92(9):2167-2173. doi: 10.1111/ans.17939. Epub 2022 Aug 2.
伪装成沟部胰腺炎的胰腺癌:病例报告及文献复习
JOP. 2011 Nov 9;12(6):598-602.
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Groove pancreatitis.胰管炎。
Dig Surg. 2010;27(2):149-52. doi: 10.1159/000289099. Epub 2010 Jun 10.
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Histopathology of the minor duodenal papilla.十二指肠小乳头的组织病理学。
Dig Surg. 2010;27(2):137-9. doi: 10.1159/000286920. Epub 2010 Jun 10.
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Groove pancreatic carcinoma.沟部胰腺癌
Hepatogastroenterology. 2009 Nov-Dec;56(96):1742-4.
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Differential diagnosis of groove pancreatic carcinomas vs. groove pancreatitis: usefulness of the portal venous phase.胰沟部癌与胰沟炎的鉴别诊断:门静脉期的应用价值。
Eur J Radiol. 2010 Jun;74(3):e95-e100. doi: 10.1016/j.ejrad.2009.04.026. Epub 2009 May 17.
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[Groove pancreatitis and its differential diagnosis with pancreatic adenocarcinoma].[沟部胰腺炎及其与胰腺腺癌的鉴别诊断]
Gastroenterol Hepatol. 2009 Jan;32(1):22-8. doi: 10.1016/j.gastrohep.2008.09.005. Epub 2009 Jan 1.
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[Pancreatic groove carcinoma in a young adult].[一名年轻成年人的胰腺沟部癌]
Nihon Shokakibyo Gakkai Zasshi. 2008 Jul;105(7):1078-86.
10
[Three cases of groove pancreatic carcinoma in which endoscopic ultrasonography was useful for diagnosis before surgery].[三例沟部胰腺癌病例,其中内镜超声检查在术前诊断中具有重要作用]
Nihon Shokakibyo Gakkai Zasshi. 2008 Jul;105(7):1061-9.