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目的 胰腺间变癌是少见的胰腺外分泌恶性肿瘤,本文探讨其临床病理学特点。方法 回顾性分析6例胰腺间变癌的临床特点并结合文献讨论。结果本组6例,其中男5例,女1例,年龄45 ~74岁。肿瘤位于胰头3例,胰体尾3例。行胰头十二指肠切除术3例,其中1例作肠系膜上静脉切除重 建术,另1例同时行肠系膜上动、静脉切除重建术。3例胰体尾肿块,2例行胰体尾切除、脾切除术,另1例 肿瘤已侵犯周围脏器,行全胃、结肠脾曲、腹腔动脉切除术。病理检查:肿瘤细胞呈多形性,可见圆形、卵 圆形、多边形和梭形的肿瘤细胞,核大深染,异型明显,也可见巨核或多核的瘤巨细胞及破骨细胞样巨细 胞。随访5例,术后平均生存5.5月,均死于肿瘤腹腔内和肝脏转移。结论 胰腺间变癌组织学特点为肿 瘤细胞的多形性,并可见巨核或多核的巨细胞或破骨细胞样巨细胞,呈侵袭性生长,易侵犯周围脏器、大 血管和发生肝脏、淋巴结转移,恶性程度高,预后差。
The purpose of pancreatic cancer is a rare pancreatic exocrine cancer, this paper discusses its clinical and pathological features. Methods Retrospective analysis of 6 cases of pancreatic cancer between the clinical features and literature review. Results The group of 6 patients, including 5 males and 1 female, aged 45 to 74 years. Tumor in the head of the pancreas in 3 cases, 3 cases of pancreatic body tail. Three cases of pancreaticoduodenectomy, including one case of superior mesenteric vein resection and reconstruction, another case of simultaneous mesenteric upper and lower venous remodeling. 3 cases of pancreatic body mass, 2 cases of pancreatic body tail resection, splenectomy, the other one case of tumor has been infiltrated around organs, the whole stomach, colon splenic song, celiac artery resection. Pathological examination: Tumor cells were pleomorphic, showing round, oval, polygonal and spindle-shaped tumor cells, nuclear deep stained, abnormal shaped, also visible megakaryocytes or multinucleated tumor giant cells and osteoclast-like giant cells . All the patients were followed up for 5 cases. The average survival time was 5.5 months after operation, both of them died of tumor intraperitoneal and liver metastasis. Conclusion The histological features of the inter-pancreatic cancerous tissue are pleomorphic of the tumor cells, and the giant cells or multinucleated giant cells or osteoclast-like giant cells of the pancreas show invasive growth and easily invade the surrounding organs, blood vessels, and the liver and lymph nodes Metastasis, high grade, poor prognosis.