论文部分内容阅读
目的 研究各种类型壶腹周围癌之间的区别与联系。方法 回顾性分析1980年1月至2003年12月收治的631例壶腹周围癌患者的临床表现、病理行为和术后生存情况。结果 胰头癌(352例)、胆总管癌(42例)、壶腹癌(189例)、十二指肠癌(48例)等壶腹周围癌存在以下差异:(1)平均症状持续时间(周)分别为11. 9±1. 3、5. 8±0 .9、6. 3±0. 6、18 .3±4 .0 (F=6 .18,P<0. 01);(2)血清总胆红素水平(μmol/L)分别为225±10、345±35、235±13、50±13 (χ2 =68 .49,P<0 01 );(3)肿瘤平均直径(cm)分别为6 .0±2. 2、3 0±1 .3、3 .0±1 .9、4. 8±3. 9 (χ2 =255. 7,P<0 01 ); ( 4 )腺癌分化程度(χ2 =9 .70,P<0 .05); (5)肿瘤切除后的T分期(χ2 =11. 68,P<0 .01 )和淋巴结状态(χ2 =8 33,P<0. 05); (6)无法切除肿瘤的十二指肠侵犯(χ2 =10. 76,P<0 .01 )、胆总管侵犯(χ2 =15 16,P<0 .01)、壶腹周围组织侵犯(χ2 =22. 49,P<0. 01)、大血管侵犯(χ2 =51 25,P<0 .01); (7)手术切除率13% (46例)、50% (21例)、74% (139例)、56% (27例) (χ2 =205 6,P<0. 01); (8)术后中位生存期(月)分别为6.0±0 3、13. 0±1 .2、22. 0±1 6、13 .0±2 .5 (χ2 =173. 47,P<0 .01 )。结论 不同类型壶腹周围癌的临床表现、病理学行为、手术切
Objective To study the difference and relationship between various types of periampullary carcinoma. Methods The clinical manifestations, pathological behaviors and postoperative survival of 631 patients with periampullary carcinoma who were treated from January 1980 to December 2003 were analyzed retrospectively. (352 cases), common bile duct carcinoma (42 cases), ampulla carcinoma (189 cases), duodenal cancer (48 cases), etc. There were the following differences in periampullar carcinoma: (1) mean duration of symptoms (Weeks) were 11. 9 ± 1. 3,5. 8 ± 0 .9,6. 3 ± 0. 6,18 .3 ± 4 .0 (F = 6.18, P <0.01); (2) Serum total bilirubin levels (μmol / L) were 225 ± 10,345 ± 35,235 ± 13,50 ± 13 (χ2 = 68.49, P <0.01) (cm) were 6 .0 ± 2. 2,3 0 ± 1 .3,3. 0 ± 1 .9,4. 8 ± 3 9 (χ2 = 255.7, P <0.01); (4 ) (P <0.05); (5) The T stage (χ2 = 11.68, P <0.01) and lymph node status (χ2 = 833, P <0.05); (6) Duodenum invasion (χ2 = 10.76, P <0.01), common bile duct invasion (χ2 = 15 16, P < Abdominal peritumoral invasion (χ2 = 22.49, P <0.01), macrovascular invasion (χ2 = 51.25, P <0.01); (7) Surgical resection rate was 13% 21 cases), 74% (139 cases) and 56% (27 cases) (χ2 = 205 6, P <0.01). The median postoperative survival time was 6.0 ± 0.3 .0 ± 1 .2,22. 0 ± 1 6,13 .0 ± 2 .5 (χ2 = 173.47, P <0.01). Conclusions The clinical manifestations, pathological behavior and surgical resection of different types of ampulla surrounding cancer