González Martínez J, Truan Alonso N, Turienzo E, Martínez D, Florez L
Servicio de Cirugía General: I-A, Hospital Central de Asturias, Oviedo.
Rev Esp Enferm Dig. 1995 Sep;87(9):653-7.
Pancreatic adenocarcinoma continues increasing in frequency, its diagnosis is usually realized very late and the results of the surgery, that is the only possibility of cure, gives often a feeling of frustration. During the period between 1973 and 1992, 1032 patients were diagnosed of pancreatic carcinoma at the different hospital institutions of our region. The incidence has increased from 1.28 to 6.42 cases/100,000. The proportion male/female was 1.5/1. Mean age of the patients was 67.5 +/- 11.35 and the median age was 65 years. In relation with the sex, the women age was higher: 70.2 +/- 11.81 (p < 0.01). The best diagnostic test was the CAT scan with 87.5 sensitivity. The overall resectability rate was low (11%), but there is a large difference between the beginning and the end of the period (6.8% and 14.1% respectively). Staging of the disease was stage IV in 36.4% of the cases. The 66.5% of the patients underwent palliative surgery. Cholecystojejunostomy was the most frequent operation. It wasn't possible any surgical management at the 3.5% of the cases cause of the disease was very extended; laparotomy was the only method used in 18.7%. The average survival rate with exeresis surgery was 18 months; with palliative surgery, it was only of eight months. The natural history of pancreatic carcinoma was situated at 5.57 +/- 2.63.
胰腺癌的发病率持续上升,其诊断通常很晚才得以实现,而手术是唯一的治愈可能性,但其结果往往令人沮丧。在1973年至1992年期间,我们地区不同医院机构诊断出1032例胰腺癌患者。发病率从每10万人1.28例增加到6.42例。男女比例为1.5:1。患者的平均年龄为67.5±11.35岁,中位年龄为65岁。按性别划分,女性年龄更大:70.2±11.81岁(p<0.01)。最佳诊断检查是CT扫描,敏感度为87.5%。总体可切除率较低(11%),但在这一时期开始和结束时存在很大差异(分别为6.8%和14.1%)。36.4%的病例疾病分期为IV期。66.5%的患者接受了姑息性手术。胆囊空肠吻合术是最常见的手术。3.5%的病例因疾病广泛无法进行任何手术治疗;剖腹手术是18.7%的病例中唯一使用的方法。根治性手术的平均生存率为18个月;姑息性手术的平均生存率仅为8个月。胰腺癌的自然病程为5.57±2.63。