摘要
目的探讨胰腺囊腺瘤和囊腺癌的临床病理特点及其诊治方法。方法对我院2002年1月至2012年9月收治的165例胰腺囊性肿瘤患者的临床及病理资料进行回顾性分析。结果胰腺囊性肿瘤好发于中年女性,临床表现缺乏特异性,其中74例患者因体检时行B超或CT等影像学检查发现胰腺囊性占位来院就诊,影像学检查虽然是发现病灶的主要检查方法,但不能确定疾病病理类型。肿瘤位于胰腺头部40例,胰腺颈部34例,胰腺体尾部91例;行不同术式的肿瘤切除160例,剖腹探查、肿瘤活检3例,行胃空肠转流术2例。患者术前免疫学指标糖链抗原125(CA125)单项指标检测的特异度显著高于糖链抗原19-9(CA19-9)单项指标检测以及联合检测的特异度(P<0.05)。结论在鉴别诊治胰腺囊腺瘤和囊腺癌患者中,结合患者术前影像学检查结果和免疫学肿瘤指标检测结果,有助于提高术前预判的准确性。由于CA19-9在良性疾病中也有升高现象,所以CA125检测有助于减少这种假阳性的结果。手术切除是胰腺囊腺瘤和囊腺癌的主要治疗手段。
Objective To investigate the clinical and pathological features of pancreatic cystadenoma and cystadenocarcinoma and its diagnostic and treatment methods. Methods The clinical and pathological data in our hospital from Jan. 2002 to Sep. 2012 in 165 patients were retrospectively analyzed. Results Pancreatic cystic tumors appeared mostly in middle-aged women, the clinical manifestations lacked of specificity, of whom 74 cases went to hospital and see doctor, because space occupying lesion was found in B-ultrasound or CT imaging of pancreatic cystic mass of physical examination, though imaging examination was the main inspection methods for discovering the foci, but couldn＇t determine the type of disease. Tumor in the pancreatic head was found in 40 cases, 34 cases in pancreatic neck, body and tail of the pancreas were found in 91 cases, the different surgical tumor resection was performed in 160 cases, laparotomy and tumor biopsy in three cases, gastric ileum bypass surgery in two cases. Specificity of immunological parameters preoperative cancer antigen 125 individual indicators was significantly higher than the specificity of 19-9 individual indicators cancer antigen detection and joint detection（P〈0.05）. Conclusion Indentification of pancreatic cystadenoma and cystadenocarcinoma diagnosis and treatment of patients, the combination of preoperative imaging findings and immunological tumor marker test results will help predict before surgery to improve the accuracy. Because of cancer antigen 19-9 in benign disease has elevated phenomenon, so cancer antigen 125 test can help reduce this false-positive results. Surgical resection of pancreatic cystadenoma and cystadenocarcinoma is the main treatment.
出处
《肝胆胰外科杂志》
CAS
2015年第1期9-11,共3页
Journal of Hepatopancreatobiliary Surgery
