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目的:探讨胰腺腺鳞癌诊治经验,以提高对该病的认识和诊治水平。方法:回顾性分析2002年6月—2014年6月期间收治的6例胰腺腺鳞癌患者的临床资料并结合相关文献进行讨论。结果:6例患者中,肿瘤位于胰头部者3例,位于胰体尾部者3例;平均年龄63.3岁;主要症状为腹痛和小便发黄;CA19-9升高5例;CT等影像学检查均提示胰腺占位病变;行胰头十二指肠切除术2例,胰体尾部加脾切除3例;1例术中发现肿瘤侵及胃后壁、十二指肠降部,行姑息性手术治疗;镜下病理检查均可见腺癌和鳞癌成分混杂。术后随访,死亡4例,失访1例,术后生存7~56个月,平均21个月。结论:胰腺腺鳞癌是一种罕见肿瘤,恶性程度高,术前诊断困难,预后差,但手术切除仍是首选治疗手段,通过联合放化疗的综合治疗可能提高疗效。
Objective: To explore the diagnosis and treatment of pancreatic adenosquamous carcinoma in order to improve the understanding of the disease and diagnosis and treatment. Methods: The clinical data of 6 patients with adenosquamous carcinoma of the pancreas admitted from June 2002 to June 2014 were retrospectively analyzed and discussed with relevant literatures. Results: Of the 6 patients, 3 were located in the head of the pancreas and 3 were located in the tail of the pancreas. The mean age was 63.3 years old. The main symptoms were abdominal pain and urination yellowing; elevated CA19-9 in 5 cases; CT imaging 2 cases of pancreaticoduodenectomy, 3 cases of pancreatic body tail plus splenectomy; 1 case of tumor invasion and the back wall of the stomach, duodenum descending, line palliative Sexual surgery; microscopic examination of both adenocarcinoma and squamous cell carcinoma can be mixed. Follow-up postoperatively, 4 patients died and 1 patient was lost. The patients survived for 7 to 56 months (average 21 months). Conclusions: Pancreatic adenosquamous carcinoma is a rare tumor with a high degree of malignancy. It is difficult to diagnose preoperatively and has a poor prognosis. Surgical resection is still the first choice of treatment. Combined treatment with radiotherapy and chemotherapy may improve the curative effect.