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目的探讨肾细胞癌继发胰腺转移的诊治原则。方法回顾性分析2000-2013年北京大学第一医院普通外科收治的5例病理诊断明确、随访完整的肾细胞癌继发胰腺转移病人的临床资料。结果 5例病人分别于肾癌术后20个月,7、11、12及15年出现胰腺转移,术前结合病史及CT、内镜超声(EUS)等检查多可明确诊断。2例病人因病灶多发行全胰腺切除术,另2例病人根据单发病灶位置行胰十二指肠切除术,余1例病人未行手术治疗。4例经手术治疗的病人中3例仍存活,随访中未见肿瘤复发转移;另1例于术后1年余因心脑血管疾病死亡,未经手术治疗的1例病人于发现转移灶后6年因上消化道出血死亡。结论对于可切除的肾细胞癌继发胰腺转移病人,不同范围的切除手术可根治肿瘤,延长病人生存期。
Objective To investigate the diagnosis and treatment of renal cell carcinoma secondary to pancreatic metastasis. Methods The clinical data of 5 patients with clear diagnosis and complete follow-up of patients with metastatic renal cell carcinoma of pancreas were retrospectively analyzed from 2000 to 2013 in General Surgery, Peking University First Hospital. Results Five patients had pancreatic metastases at 20, 7, 11, 12 and 15 years after operation. The diagnosis of pancreatic metastasis was preoperatively combined with the history of surgery and CT, endoscopic ultrasonography (EUS). Two patients underwent total pancreatectomy due to multiple lesions, while the other two patients underwent pancreaticoduodenectomy according to the location of the single lesion. The remaining one patient did not undergo surgical treatment. 3 of the 4 surgically treated patients survived, and no tumor recurrence and metastasis was observed during the follow-up. The other 1 patient died of cardiovascular and cerebrovascular diseases more than 1 year after operation. One patient who had not undergone surgery was found to have metastasis 6 years died of upper gastrointestinal bleeding. Conclusion For patients with resectable renal cell carcinoma secondary to pancreatic metastasis, different ranges of resection can cure the tumor and prolong the survival of patients.