Kimura W, Kuroda A, Makuuchi M
Department of Surgery, Faculty of Medicine, University of Tokyo, Japan.
Pancreas. 1998 Apr;16(3):363-9. doi: 10.1097/00006676-199804000-00025.
Reports of a so-called "mucin-producing tumor of the pancreas" are increasing worldwide. Although the clinicopathologic features and therapeutic strategies of this tumor have been enthusiastically investigated, there are still many unanswered questions regarding this ailment. In this study, problems in the diagnosis and treatment of mucin-producing tumor were analyzed, based on the 259 reported cases of this tumor. The overall 5-year survival rate for resected cases is 83%, which is much higher than that for ordinary duct cell carcinoma (17.3%). However, the 5-year survival rate for carcinoma cases with infiltration into other organs is 28%, which is much lower than those for carcinoma cases without infiltration (86%) and carcinoma cases with infiltration that remained within the pancreatic parenchyma (74%). These results demonstrate that patients with this tumor have a poor prognosis if the tumor infiltrates other organs. In addition, when the spread of the tumor is >6 cm, the prognosis is significantly worse than when the tumor has a spread of <6 cm. The significance of using the presence of K-ras mutation in the pancreatic juice for diagnosis of this tumor and problems of duodenum-preserving pancreatic head resection are discussed.
全球范围内，所谓“胰腺黏液生成性肿瘤”的报道日益增多。尽管对该肿瘤的临床病理特征及治疗策略已展开积极研究，但关于这种疾病仍存在诸多未解之谜。本研究基于259例已报道的该肿瘤病例，分析了黏液生成性肿瘤在诊断和治疗方面的问题。手术切除病例的总体5年生存率为83%，远高于普通导管细胞癌（17.3%）。然而，浸润至其他器官的癌病例5年生存率为28%，远低于未浸润癌病例（86%）以及浸润局限于胰腺实质内的癌病例（74%）。这些结果表明，该肿瘤患者若肿瘤浸润其他器官，预后较差。此外，当肿瘤扩散范围>6 cm时，预后明显差于扩散范围<6 cm的肿瘤。文中还讨论了利用胰液中K-ras突变进行该肿瘤诊断的意义以及保留十二指肠的胰头切除术的问题。
