胰腺癌的预后不佳.作者回顾了Toledo医院自1952～1992年154例胰腺外分泌腺癌尸检的资料,从中观察其发展类型和结果.全组中,男性87例,女性67例,年龄41～91岁,19例伴其它原发肿瘤,如前列腺、结肠、肺、乳腺、小肠和喉等,胰腺肿瘤位于头部75例,体尾部39例,弥散40例.第1组138例中,50例未作手术或放疗,88例仅作活检或转流手术;第2组16例中,10例作根治术,另6例作姑息性手术和大剂量放疗.肿瘤分期计Ⅰ、Ⅱ、Ⅲ和Ⅳ在第Ⅰ组分别占10、11和117例,而第2组分别占4、3和9例.分析结果 (1)胰内扩散 24例由于肿瘤太大而不能估计其起源部位,12例有胰内转移或多中心病灶.(2)肿瘤大小和转移不明,但肿瘤大小与其分期有关,间接提示肿瘤越大,转移机会越多.在91例第1组病人中,肿瘤>6.0cm者,Ⅰ～Ⅱ、Ⅲ和Ⅳ期分别占6、8和84例.(3)腹膜弥散 胰体尾部癌的腹膜弥散率比胰头部为高(P<0.05).(4)并发症胰头癌多伴发胆道梗阻、幽门或十二指肠梗阻和出血,而胰体尾癌多见小肠和结肠并发症(梗阻、穿孔和缺血).7例的胰腺癌发生在原有的慢性胰腺炎基础上,血栓栓塞并发症共有30例,尤多见于胰体尾部生成粘液的肿瘤.在21例,其腹水量与腹膜弥散的严重度不呈正相关.(5)淋巴结转移 共99例.胰体尾部癌的淋巴转移相对比胰头部多些.第1组有记录的 The prognosis of pancreatic cancer is poor. The authors reviewed data from 152 autopsy cases of pancreatic exocrine adenocarcinoma from Toledo Hospital from 1952 to 1992. The developmental types and results were observed. There were 87 males and 67 females in the whole group. 91-year-old, 19 patients with other primary tumors, such as prostate, colon, lung, breast, small intestine and laryngeal, pancreatic tumors located in the head 75 cases, body and tail 39 cases, diffuse 40 cases. Group 1 138 cases, 50 Cases were not treated with surgery or radiotherapy. 88 cases were only used for biopsy or bypass surgery; in the second group of 16 cases, 10 cases were treated with radical surgery, and 6 cases were treated with palliative surgery and high-dose radiation therapy. The tumor staging system I, II, III And IV in the first group accounted for 10, 11 and 117 cases respectively, while the second group accounted for 4, 3 and 9 cases. Analysis of results (1) Intrapancreatic spread in 24 cases because the tumor is too large to estimate its origin, 12 Cases with pancreatic metastasis or multicentric lesions. (2) tumor size and metastasis is unknown, but the size of the tumor and its staging, indirectly suggest that the larger the tumor, the greater the chance of metastasis. In 91 patients in the first group, the tumor> 6.0cm Among them, stage I-II, III and IV accounted for 6, 8 and 84 cases respectively. (3) Peritoneal diffused pancreatic body and tail cancer had higher peritoneal diffusion rate than pancreatic head (P<0.05). (4) The pancreatic head cancer was often associated with biliary obstruction, pyloric or duodenal obstruction, and hemorrhage. Pancreatic cancer was more common in small intestine and colon complications (obstruction, perforation, and ischemia). Pancreatic cancer occurred in 7 cases. On the basis of chronic pancreatitis, there were 30 cases of thromboembolic complications, especially in pancreatic body and mucous tumors. In 21 cases, the amount of ascites was not positively correlated with the severity of peritoneal diffusion. (5) Lymph node metastasis Example: Lymphatic metastasis of the pancreatic body and tail cancer is relatively more than that of the pancreatic head. The first group has recorded