论文部分内容阅读
目的 :探索临床特点、常用辅助检查对胰腺囊性肿瘤(pancreatic cystic neoplasm,PCN)术前恶性预测的价值。方法:回顾性分析我院2003年1月至2015年4月收治342例PCN病人病史资料,运用t检验、卡方检验分析各项指标对PCN术前恶性预测能力的差异。通过Logistic回归分析P<0.20的指标,获得预测恶性PCN的独立因素。结果:临床特点上有临床症状、男性、年龄>55岁、糖尿病、高血压,辅助检查中CA19-9、CEA异常升高,影像学检查发现病灶位于胰腺近端(胰腺头颈部,钩突部)、胰管扩张、实性肿块、病灶直径≥3 cm,均有助于预测恶性PCN。有临床症状、糖尿病史、CA19-9升高、CEA升高、影像学检查发现实性肿块、病灶直径≥3 cm是术前预测恶性PCN的独立因素。超声内镜引导细针穿刺(endoscopic ultrasound-guided fine-needle aspiration,EUS-FNA)检查细胞学结果可对PCN术前恶性预测有帮助。结论:病人有临床症状、糖尿病史、CA19-9升高、CEA升高、病灶为实性肿块、病灶直径≥3 cm对术前预测恶性PCN有积极意义,EUS-FNA检查结果对术前预测恶性PCN有一定帮助。
Objective: To explore the clinical features and the value of common auxiliary examination in the preoperative malignancy of pancreatic cystic neoplasm (PCN). Methods: A retrospective analysis of our hospital from January 2003 to April 2015 admitted 342 cases of PCN patient history data, the use of t test, chi-square test analysis of the various indicators of PCN preoperative malignant ability to predict differences. Logistic regression analysis of the index P <0.20, to obtain independent predictors of malignant PCN. Results: The clinical characteristics of clinical symptoms, male, age> 55 years old, diabetes, hypertension, auxiliary examination of CA19-9, CEA abnormal increased imaging found that lesions located in the proximal pancreas (pancreatic head and neck, Department), pancreatic duct dilatation, solid mass, lesion diameter ≥ 3 cm, are helpful to predict malignant PCN. There are clinical symptoms, diabetes mellitus, elevated CA19-9, elevated CEA, imaging examination found solid lumps, lesions diameter ≥ 3 cm is an independent predictor of malignant PCN independent factors. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) examination cytology results may be helpful in predicting PCN malignancy. Conclusions: The patients had clinical symptoms, diabetes mellitus, elevated CA19-9, elevated CEA, solid tumor mass, and the diameter of the tumor ≥3 cm, which had positive significance in predicting malignant PCN before operation. The results of EUS-FNA preoperatively Malignant PCN have some help.