摘要
目的 探讨40岁以下青年胰腺恶性肿瘤患者的临床特点,以提高青年人胰腺恶性肿瘤早期诊断水平和治疗效果.方法 回顾性分析46例40岁以下青年胰腺恶性肿瘤的临床表现、临床病理参数、血清CA19-9和CEA水平、误诊情况、治疗与生存时间.结果 青年胰腺恶性肿瘤患者首发症状主要为:上腹部饱胀(78.26%)、上腹部不适(73.91%)、消瘦(73.91%)、食欲不振(69.57%)、腹痛(60.87%);肿瘤多位于胰头部(52.17%);病理证实30例(65.22%)发生转移,其中13例累及多器官;胰腺外分泌肿瘤占72.73%(24/33),胰腺内分泌肿瘤占27.27%(9/33);CA19-9和CEA阳性率分别为73.91%(34/46)、32.61%(15/46);误诊率为80.43%(37/46),主要误诊为急、慢性胃炎(36.96%);根治性手术率为23.91%;平均生存期12.6个月.结论 40岁以下青年人胰腺恶性肿瘤早期无特异性临床表现、误诊率高、预后差,应重视早期诊断.
Objective To improve the diagnostic and therapeutic efficacy for young patients with malignant tumors of pancreas at the early stage, and describe the clinical characteristics of this group of patients. Methods The clinical data of 46 young patients less than forty years old with malignant tumors of pancreas received treatment and follow up, including clinical features, clinicopathological parameters, status of misdiagnosis, CA 19-9, CEA, were retrospectively reviewed. Results The main manifestations of young patients with malignant tumors of pancreas were abdominal bloating (78.26% ), epigastric discomfort (73.91%), weight loss (73.91%), loss of appetite (69.57%), abdominal pain (60.87%). Majority of the tumors were located in pancreatic head. 30 cases (65.22%) had pathological evidence of metastasis, among them 13 cases had multi-organ involvement. Pancreatic exocrine tumor accounted for 72.73% (24/33) of all the tumors, while endocrine tumor accounted for 27.27% (9/33). The positive rates of CA 19-9 and CEA were 73.91% (34/46) and 32.6% (15/46). The misdiagnosis rate of young patients with malignant tumors of pancreas was up to 80.43% (37/46). The main misdiagnoses were acute or chronic gastritis (36.96%). The rate of radical operation for young patients with malignant tumors of pancreas was 23.91%, and the median survival was 12.6 months. Conclusions The symptoms of young patients with malignant pancreatic tumors are non-speciflc and the misdiagnosis rate was high and the prognosis was poor, therefore, the early diagnosis of pancreatic malignant tumors shall be emphasized.
出处
《中华胰腺病杂志》
CAS
2008年第3期-,共3页
Chinese Journal of Pancreatology
