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目的 胰腺腺鳞癌是一种临床罕见的胰腺外分泌恶性肿瘤 ,本文探讨其临床病理学特点和诊断治疗方法。方法 回顾性分析 8例胰腺腺鳞癌的临床特点并结合文献讨论。结果 本组 8例胰腺腺鳞癌病人 ,其中男 7例 ,女 1例 ,平均年龄 (6 9 3± 11 8)岁。肿瘤位于胰头 5例 ,胰体 2例 ,胰尾 1例。行胰头十二指肠切除术 4例 ,其中 1例行保幽术式 ,1例合并区域淋巴结清扫术 ,1例合并肠系膜上动、静脉切除重建术。另 1例胰头肿块术中发现肝转移 ,行胆囊空肠襻式吻合术 ;3例胰体尾肿块 ,2例行胰体尾切除、脾切除术 ,另 1例肿瘤已侵犯胃底 ,行胰体尾、脾脏切除术合并部分胃切除术。病理检查 :瘤体平均 4 5cm ,肿瘤原发灶和肝转移灶均呈腺癌和鳞癌混杂表现。肿瘤呈浸润性生长的特点。 5例胰头肿块中 ,肿瘤侵犯十二指肠 2例 ,侵犯肠系膜上静脉 1例 ,肝转移 1例 ;1例胰体肿瘤侵犯脾静脉 ,1例胰尾肿瘤侵犯胃壁肌层。镜下见肿瘤侵犯神经 2例 ,淋巴结转移 2例。随访 6例 ,术后生存 3～ 7个月 ,平均生存 5 5个月 ,均死于肿瘤复发和肝转移。结论 胰腺腺鳞癌以腺癌和鳞癌混合为组织学特点 ,呈侵袭性生长的特点 ,易侵犯周围脏器、大血管和肝脏、淋巴结转移 ,恶性程度高 ,预后差
Purpose Pancreatic adenosquamous carcinoma is a rare clinical pancreatic exocrine malignant tumor. This article discusses its clinicopathological features and diagnosis and treatment. Methods The clinical features of 8 patients with adenosquamous carcinoma of the pancreas were retrospectively analyzed and discussed. Results The group of 8 patients with pancreatic adenosquamous carcinoma, including 7 males and 1 females, the average age (69 3 ± 118) years. The tumor was located in 5 cases of pancreatic head, pancreatic body in 2 cases, pancreatic tail in 1 case. Four cases underwent pancreatoduodenectomy, including one undergoing conservative surgery, one with regional lymph node dissection, and one with superior mesenteric and venous resection and reconstruction. The other 1 case of pancreatic head lumps found liver metastasis, gallbladder jejunal 襻 anastomosis; 3 cases of pancreatic body mass, 2 cases of pancreatic body excision, splenectomy, and the other 1 case of tumor has been infiltrating the stomach, pancreas Body tail, splenectomy combined with partial gastrectomy. Pathological examination: an average of 45cm tumor, primary tumor and liver metastases showed mixed adenocarcinoma and squamous cell carcinoma. Tumor was invasive growth characteristics. In 5 cases of pancreatic head mass, the tumor infiltrated the duodenum in 2 cases, the superior mesenteric vein in 1 case and the liver metastasis in 1 case. One case of pancreatic tumor invaded the splenic vein and 1 case of pancreatic tail tumor invaded the gastric wall. Microscope tumor invasion of nerve in 2 cases, 2 cases of lymph node metastasis. Follow-up in 6 cases, postoperative survival of 3 to 7 months, the average survival of 5 5 months, died of tumor recurrence and liver metastases. Conclusions Pancreatic adenosquamous carcinoma is characterized by its aggressive growth with adenocarcinoma and squamous cell carcinoma. It is easy to invade peripheral organs, blood vessels and liver, with lymph node metastasis, with high malignancy and poor prognosis