Nakao A, Ichihara T, Nonami T, Harada A, Takagi H, Koshikawa T, Nagura H
Nihon Geka Gakkai Zasshi. 1987 Jun;88(6):735-42.
Clinicohistopathological and immunohistochemical studies on intrapancreatic spread of pancreatic carcinoma were performed on 30 cases with total pancreatectomy accompanied by portal vein resection. In the observation of HE stained tissue sections of 25 cases of carcinoma of head of the pancreas, the intrapancreatic spread from the head to body or tail was observed in 9 out of 25 cases (36%). However, by the immunostaining of CEA, CA19-9 and Dupan 2, small cancer nests surrounded by fibrous tissues could be easily detected and intrapancreatic continuous spread from the head to body or tail was observed in 15 out of 25 cases (60%). The intrapancreatic spread of the carcinoma correlated with portal invasion of carcinoma, hardness of the body and tail, obstruction of main pancreatic duct and irregular pancreaticogram. The intraoperative quick immunostaining on the cryostat sections of the pancreatic tissue, together with the HE staining, is useful to determine the intrapancreatic spread of the carcinoma. The indication of total pancreatectomy for pancreatic carcinoma can be determined by these results.
对30例行全胰切除术并门静脉切除的病例进行了胰腺癌胰内扩散的临床组织病理学和免疫组织化学研究。在观察25例胰头癌的HE染色组织切片时，25例中有9例（36%）观察到癌从胰头向胰体或胰尾的胰内扩散。然而，通过CEA、CA19 - 9和Dupan 2免疫染色，可轻易检测到被纤维组织包围的小癌巢，25例中有15例（60%）观察到癌从胰头向胰体或胰尾的胰内连续扩散。癌的胰内扩散与癌的门静脉侵犯、胰体和胰尾硬度、主胰管梗阻及胰腺造影异常有关。术中对胰腺组织冰冻切片进行快速免疫染色并结合HE染色，有助于确定癌的胰内扩散。可根据这些结果确定胰腺癌全胰切除术的适应证。
