胰腺外科专题研究(Monographic Study of Pancreatic Surgery)

胰腺腺鳞癌的诊断与治疗:附6 例报告

Published at: 2015年第24卷第3期

孟庆才 1 , 王洪成 1 , 黄新余 1
1 上海交通大学附属第六人民医院 普通外科,上海 200233
通讯作者 新余 黄 Email: 18930177490@163.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.03.008
基金:

摘要

目的:探讨胰腺腺鳞癌诊治经验,以提高对该病的认识和诊治水平。 方法:回顾性分析2002 年6 月—2014 年6 月期间收治的6 例胰腺腺鳞癌患者的临床资料并结合相关 文献进行讨论。 结果:6 例患者中,肿瘤位于胰头部者3 例,位于胰体尾部者3 例;平均年龄63.3 岁;主要症状为腹痛 和小便发黄;CA19-9 升高5 例;CT 等影像学检查均提示胰腺占位病变;行胰头十二指肠切除术2 例, 胰体尾部加脾切除3 例;1 例术中发现肿瘤侵及胃后壁、十二指肠降部,行姑息性手术治疗;镜下病理 检查均可见腺癌和鳞癌成分混杂。术后随访,死亡4 例,失访1 例,术后生存7~56 个月,平均21 个月。 结论:胰腺腺鳞癌是一种罕见肿瘤,恶性程度高,术前诊断困难,预后差,但手术切除仍是首选治疗手段, 通过联合放化疗的综合治疗可能提高疗效。


Diagnosis and treatment of adenosquamous carcinoma of the pancreas: a report of 6 cases

Abstract

Objective: To discuss the experience regarding the diagnosis and treatment of adenosquamous carcinoma of the pancreas so as to improve the knowledge and management of this disease. Methods: The clinical data of 6 patients with adenosquamous carcinoma of pancreas admitted from June 2002 to June 2014 were retrospectively analyzed and discussed with review of the related literature. Results: Of the 6 patients, the lesion was located in the head of the pancreas in 3 cases, and in the body and tail of the pancreas in 3 cases; the average age was 63.3 years. The main symptoms included abdominal pain and yellow urine, and the CA19-9 level was increased in 5 cases. In all of the cases, a space-occupying lesion of the pancreas was suspected by CT and other imaging examinations. Two cases underwent pancreaticoduodenectomy, three cases underwent resection of the body and tail of the pancreas plus splenectomy, and one case had palliative surgery due to involvement of the posterior wall of the stomach and the descending part of the duodenum. Microscopic pathological examination showed that all the tumors consisted of a mixture of adenocarcinoma and squamous cell carcinoma. At postoperative follow-up, 4 cases had died, one case was lost to follow up, and the mean survival time was 21 (7–56) months. Conclusion: Adenosquamous carcinoma of the pancreas is a rare tumor with high malignancy, difficult preoperative diagnosis and poor prognosis. Surgery is still the first therapeutic option for this condition, and its efficacy may be probably improved through combination with radiotherapy and chemotherapy.


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引用

引用本文: 庆才 孟, 洪成 王, 新余 黄. 胰腺腺鳞癌的诊断与治疗:附6 例报告[J]. 中国普通外科杂志, 2015, 24(3): 347–351.
Cite this article as: MENG Qingcai, WANG Hongcheng, HUANG Xinyu . Diagnosis and treatment of adenosquamous carcinoma of the pancreas: a report of 6 cases [J]. Chin J Gen Surg, 2015, 24(3): 347–351.