Tsuchiya R, Oribe T, Noda T
Am J Gastroenterol. 1985 Jun;80(6):459-62.
Extent of the tumor in carcinoma of the pancreas seems an important factor in stage classification. The purpose of this report is to present the results of studies on the relationship between the size of the tumor (T) and prognosis, and the correlation between the size and the other factors influencing prognosis such as invasion to the pancreatic capsule, invasion to the retroperitoneal tissue, metastasis to the regional lymph node, and so on. T was divided into four groups: T1, T2, T3, T4. Tumor diameter of 2 cm or less was designated as T1, 2.1-4 cm as T2, 4.1-6 cm as T3, and 6.1 cm or more as T4. Case reports of 163 patients who underwent resection of carcinoma of the pancreatic head were submitted by 10 major institutions and retrospectively analyzed. There was significant differences in 1-year cumulative survival rates between T1 and T3, T1 and T4, and T1 and T2 + T3 + T4, but no significant difference in 3- or 5-year survival rates among the T groups. The incidence of no capsular invasion, no retroperitoneal invasion, and no lymph node metastasis had a tendency to decrease along with increase in tumor size and the incidence of definite capsular invasion, and lymph node metastases increase with increase in the size. Attempts to diagnose tumors of less than 2 cm should be made to ameliorate the poor surgical results. However, it should be stressed that even in the T1 group regional lymph node metastases were seen in about half of the cases.
胰腺癌中肿瘤的范围似乎是分期分类中的一个重要因素。本报告的目的是展示关于肿瘤大小（T）与预后之间关系的研究结果，以及肿瘤大小与其他影响预后的因素（如侵犯胰腺被膜、侵犯腹膜后组织、区域淋巴结转移等）之间的相关性。T分为四组：T1、T2、T3、T4。肿瘤直径2厘米及以下被指定为T1，2.1 - 4厘米为T2，4.1 - 6厘米为T3，6.1厘米及以上为T4。10个主要机构提交了163例行胰头癌切除术患者的病例报告并进行回顾性分析。T1与T3、T1与T4、T1与T2 + T3 + T4之间的1年累积生存率存在显著差异，但T组之间的3年或5年生存率无显著差异。无被膜侵犯、无腹膜后侵犯和无淋巴结转移的发生率有随肿瘤大小增加而降低的趋势，而明确的被膜侵犯和淋巴结转移的发生率则随肿瘤大小增加而升高。应尝试诊断小于2厘米的肿瘤以改善较差的手术结果。然而，应该强调的是，即使在T1组中，约一半的病例也可见区域淋巴结转移。
