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胰腺黏液产生性肿瘤的特征与治疗

Characteristics and treatment of mucin-producing tumor of the pancreas.

作者信息

Kimura W, Makuuchi M, Kuroda A

机构信息

First Department of Surgery, Yamagata University School of Medicine, Yamagata City, Japan.

出版信息

Hepatogastroenterology. 1998 Nov-Dec;45(24):2001-8.

PMID:9951854
Abstract

BACKGROUND/AIMS: There has been no thorough clinicopathological analysis of a large number of cases with mucin-producing tumor of the pancreas. The aim of this study was to investigate the clinicopathological features of and therapeutic strategy for this ailment.

METHODOLOGY

Two hundred and fifty-nine cases of mucin-producing tumor of the pancreas were analyzed clinicopathologically.

RESULTS

Mucin-producing tumor of the pancreas was found in 177 males and 82 females (M:F=2.2:1). The mean age was 65.5 years. Jaundice, diabetes mellitus and a past history of pancreatitis were found in 15-19% of the cases. The tumor was most frequently (62%) found in the head of the pancreas. Pathologically, hyperplasia or adenoma was found in 58 cases, and adenocarcinoma in 160 cases. Five-year survival rate by the Kaplan-Meier method was 82.6% in all of the cases, and the post-operative survival curve was much better in cases with this type of carcinoma than in cases with ordinary pancreatic duct cell carcinoma (5-year survival rate: 17.3%). Organ-function preserving procedures, such as duodenum preserving subtotal resection of the head of the pancreas or spleen preserving distal pancreatectomy, might be recommended for this disease without infiltration.

CONCLUSIONS

Mucin-producing tumor has unique clinicopathological characteristics, such as the dilated main pancreatic duct or branches, dilatation of the orifice of the papilla of Vater, or a good prognosis. Organ-function preserving procedures should be recommended in some cases with this ailment.

摘要

背景/目的:尚未对大量胰腺黏液生成肿瘤病例进行全面的临床病理分析。本研究的目的是探讨该疾病的临床病理特征及治疗策略。

方法

对259例胰腺黏液生成肿瘤病例进行临床病理分析。

结果

胰腺黏液生成肿瘤患者中男性177例,女性82例(男:女 = 2.2:1)。平均年龄为65.5岁。15 - 19%的病例出现黄疸、糖尿病和胰腺炎病史。肿瘤最常见于胰腺头部(62%)。病理检查发现,58例为增生或腺瘤,160例为腺癌。采用Kaplan-Meier法计算的所有病例5年生存率为82.6%,此类癌患者的术后生存曲线明显优于普通胰腺导管细胞癌患者(5年生存率:17.3%)。对于无浸润的该疾病,可能推荐保留器官功能的手术,如保留十二指肠的胰头次全切除术或保留脾脏的胰体尾切除术。

结论

胰腺黏液生成肿瘤具有独特的临床病理特征,如主胰管或分支扩张、 Vater壶腹开口扩张或预后良好。对于部分该疾病患者,应推荐保留器官功能的手术。

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