Xiong Y Y, Xu Y, Zhao Y, Sun H, Bai X Y, Wu D, Qian J M
Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2020 Feb 18;100(6):442-446. doi: 10.3760/cma.j.issn.0376-2491.2020.06.009.
To analyze the clinical features and prognosis of lung cancer patients with metastasis-induced acute pancreatitis (MIAP), and to provide clues for early diagnosis. The characteristics and prognosis of 8 patients with MIAP in lung cancer admitted to Peking Union Medical College Hospital from January 2002 to September 2019 were retrospectively analyzed and were compared with non-tumor-induced AP. Sevencases(7/8) were Mild AP, one (1/8) was Severe AP. Four patients (4/8) presented with AP as the reporting sign and lung cancer was not diagnosed until (112±36) days after the onset of AP. Clinical manifestations included abdominal pain (8/8), weight loss (4/8), nausea and vomiting (2/8), and jaundice (1/8). Stages of lung cancer were all Ⅳ.Histopathology proved that seven cases (7/8) were small cell lung cancer, and one case (1/8) was poorly differentiated adenocarcinoma. The median survival time was 11 months. Compared with non-tumor-induced AP, lung cancer patients with MIAP were older[(62±9) vs (48±15), 0.018], the incidence of primary pancreatic duct dilatation (37.5% vs 3.1%, 0.004) and abdominal lymphadenopathy (37.5% vs 6.3%, 0.017) were higher; the level of hemoglobin [105.3±15.6) g/L vs (147.9±24.8) g/L, 0.001] and hematocrit [(31.4±5.3) vs (42.5±6.1), 0.001] were lower. Patientswith MIAP in lung cancer had poor outcome and unspecific symptoms. Old age, anemia, main pancreatic duct dilatation and abdominal lymphadenopathy are diagnostic clues that merit clinical attention.
分析肺癌转移引起的急性胰腺炎(MIAP)患者的临床特征及预后,为早期诊断提供线索。回顾性分析2002年1月至2019年9月在北京协和医院住院的8例肺癌合并MIAP患者的特点及预后,并与非肿瘤性急性胰腺炎(AP)进行比较。7例(7/8)为轻症急性胰腺炎,1例(1/8)为重症急性胰腺炎。4例(4/8)以急性胰腺炎为首发表现,在急性胰腺炎发病后(112±36)天确诊肺癌。临床表现包括腹痛(8/8)、体重减轻(4/8)、恶心呕吐(2/8)、黄疸(1/8)。肺癌均为Ⅳ期。病理组织学证实7例(7/8)为小细胞肺癌,1例(1/8)为低分化腺癌。中位生存时间为11个月。与非肿瘤性急性胰腺炎相比,肺癌合并MIAP患者年龄更大[(62±9)岁 vs (48±15)岁,P = 0.018],主胰管扩张发生率(37.5% vs 3.1%,P = 0.004)和腹部淋巴结肿大发生率(37.5% vs 6.3%,P = 0.017)更高;血红蛋白水平[(105.3±15.6)g/L vs (147.9±24.8)g/L,P = 0.001]和血细胞比容[(31.4±5.3) vs (42.5±6.1),P = 0.001]更低。肺癌合并MIAP预后较差,症状不具特异性。高龄、贫血、主胰管扩张和腹部淋巴结肿大是值得临床关注的诊断线索。