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目的探讨胰腺黏液非囊性癌的组织学特点、生物学特征、治疗方法及预后。方法回顾性分析复旦大学附属中山医院普外科2000~2005年间收治的9例胰腺黏液非囊性癌病人的临床特点、影像学改变、病理学特征、治疗经过及随访资料。9例胰腺黏液非囊性癌病人,男7例,女2例,年龄平均(63·1±8·7)岁。肿瘤位于胰头8例,胰体尾1例。行胰十二指肠切除术8例,其中4例合并扩大淋巴结清扫术,1例行胰体尾切除。结果术后病理报告:瘤体平均4·3cm×4·3cm×4·4cm。镜下见8例胰头肿瘤均侵犯十二指肠,侵犯肠系膜上静脉4例。肿瘤侵犯神经3例,淋巴结转移2例。镜下肿瘤表现明确的间质黏液湖及其上漂浮较少的恶性上皮细胞。随访8例,死亡5例。术后存活5~23个月,平均存活11个月,均死于肿瘤复发和肝转移。结论胰腺黏液非囊性癌应是胰腺恶性肿瘤的一个独立的类型,其生物学特征有待进一步研究。
Objective To investigate the histological features, biological characteristics, treatment and prognosis of pancreatic mucinous non-cystic carcinoma. Methods The clinical features, imaging changes, pathological features, treatment and follow-up of 9 patients with pancreatic mucinous non-cystic carcinoma admitted to Zhongshan Hospital of Fudan University from 2000 to 2005 were retrospectively analyzed. 9 cases of pancreatic mucinous non-cystic carcinoma patients, 7 males and 2 females, average age (63 · 1 ± 8.7) years old. Tumor in the head of 8 cases, 1 case of pancreatic body tail. Pancreaticoduodenectomy in 8 cases, 4 cases of enlarged lymph node dissection, 1 case of pancreatic body excision. Results Postoperative pathology report: The average tumor size was 4. 3cm × 4 · 3cm × 4 · 4cm. Microscope, see 8 cases of pancreatic head tumors were violations of the duodenum, invaded the superior mesenteric vein in 4 cases. 3 cases of tumor invasion nerve, 2 cases of lymph node metastasis. Microscopic tumor showed clear interstitial mucus lake and its floating on the less malignant epithelial cells. Follow-up in 8 cases, 5 deaths. Postoperative survival of 5 to 23 months, the average survival of 11 months, died of tumor recurrence and liver metastases. Conclusion Pancreatic mucinous noncystic carcinoma should be an independent type of pancreatic malignant tumor. Its biological characteristics are to be further studied.