恶性与交界性胰腺囊性疾病的临床因素分析

来源 :中国肿瘤临床与康复 | 被引量 : 0次 | 上传用户:qingfeng44
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目的探讨良恶性胰腺囊性疾病(cystic lesions of the pancreas,CLP)的临床因素。方法回顾性分析手术后经病理证实的49例CLP的临床特征。结果胰腺管状腺癌囊性变5例;肉瘤样癌囊性变1例;黏液性囊性肿瘤8例(恶性2例,交界性5例,良性1例);胰腺实性假乳头状肿瘤14例(恶性1例,交界性13例);囊性胰腺内分泌肿瘤2例(良恶性各1例);浆液性囊腺瘤10例(均为良性);无恶性潜能的CLP 9例(海绵状血管瘤2例,慢性胰腺炎伴潴留性囊肿3例,胰腺黏液性非肿瘤性囊肿1例,胰腺假性囊肿1例,潴留性囊肿1例,良性上皮性囊肿1例)。恶性肿瘤组患者的年龄为(64.70±11.23)岁,明显高于交界性肿瘤组[(34.33±15.83)岁]和良性病变组[(47.29±14.068)岁]。恶性肿瘤组肿瘤最大直径(8.09±3.98)cm,明显大于良性病变组[(5.25±3.22)cm]。恶性肿瘤组CA19-9的阳性率为60.0%,明显高于交界性肿瘤组(0)和良性病变组(11.8%)。恶性肿瘤组CEA的阳性率为40.0%,其余两组均正常。CT诊断CLP的符合率为87.9%,肿瘤的边界是否清楚、有无实性成分有助于区别良恶性。结论对于男性、年龄大,血清肿瘤学标志物升高明显、影像学表现为边界不清或有实性成分的CLP患者应采取积极治疗。 Objective To investigate the clinical factors of cystic lesions of the pancreas (CLP). Methods The clinical features of 49 patients with pathologically confirmed CLP after surgery were retrospectively analyzed. Results 5 cases of pancreatic tubular adenocarcinoma cystic change; 1 case of sarcomatoid cystic degeneration; 8 cases of mucinous cystic tumor (malignant in 2 cases, borderline in 5 cases, benign in 1 case); pancreatic solid pseudopapillary tumor 14 (Malignant in 1 case, borderline in 13 cases); cystic pancreatic endocrine tumors in 2 cases (benign and malignant in 1 case); serous cystadenoma in 10 cases (all benign); non-malignant CLP in 9 cases (cavernous 2 cases of hemangioma, 3 cases of chronic pancreatitis with retention cyst, 1 case of pancreatic mucinous non-neoplastic cyst, 1 case of pancreatic pseudocyst, 1 case of retention cyst and 1 case of benign epithelial cyst. The age of malignant tumor patients was (64.70 ± 11.23) years old, which was significantly higher than that in borderline tumors [(34.33 ± 15.83) years) and benign lesions group (47.29 ± 14.068 years). The maximum diameter of malignant tumor group was (8.09 ± 3.98) cm, which was significantly higher than that of benign group [(5.25 ± 3.22) cm]. The positive rate of CA19-9 in malignant tumor group was 60.0%, which was significantly higher than that in borderline tumor group (0) and benign lesion group (11.8%). The positive rate of CEA in malignant tumor group was 40.0%, the other two groups were normal. The coincidence rate of CT diagnosis of CLP was 87.9%, the tumor border is clear, with or without solid ingredients can help distinguish between benign and malignant. CONCLUSIONS: In men, older patients with elevated serum oncology markers should be treated aggressively in patients with CLP with unclear border or solid imaging.
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