晚期胰腺癌患者的肿瘤血供来源:218例患者的DSA评价

Feeding Arteries of Advanced Pancreatic Cancer:Evaluation of 218 Patients by Digital Subtract Angiography

目的:探讨晚期胰腺癌患者的肿瘤血供来源。方法:对接受经导管动脉内灌注化疗(transcatheter arterial infusion chemotherapy,TAI)的218例晚期胰腺癌患者行数字减影血管造影(digital subtract angiography,DSA),以显示肿瘤血供来源。结果:晚期胰腺癌患者DSA造影可见血供来源146例(67.0%):其中,胰头颈部癌患者61例,其前3位供血动脉来源依次为:胰十二指肠动脉前上、后上弓(50例,82.0%),胰十二指肠动脉前下、后下弓(31例,50.8%),胰背动脉(14例,23.0%);胰体癌患者48例,主要供血动脉为:胰背动脉(35例,72.3%),肠系膜上动脉(9例,18.9%),胰大动脉(7例,14.6%);胰尾部癌患者37例,主要供血动脉为:胰尾动脉(29例,78.4%),胰大动脉(14例,38.8%),胰背动脉(3例,8.1%)。其中61例胰头颈部癌患者中有34例(55.7%)行DSA可见两支动脉血供。结论:胰腺癌患者的肿瘤血供与肿瘤位置相关:胰头颈部癌肿瘤血供大多来源于胰十二指肠动脉,胰体癌肿瘤血供多来源于胰背动脉,胰尾癌肿瘤血供多来源于胰尾动脉。

Objective： To investigate the feeding artery distribution of tumor masses in patients with advanced pancreatic canc- er. Methods：A total of 218 patients with advanced pancreatic cancer who had undergone transcatheter arterial infusion chemo- therapy（TAD were involved. The feeding artery distribution of tumor masses was displayed by digital subtract angiography （DSA） images. Results： The feeding arteries were successfully identified in 146 （67. 0%） patients. The top three feeding arteries sources in 61 cases of pancreatic head and neck tumors were superior pancreaticoduodenal artery （50 cases, 82.0%）, inferior pancreaticoduodenal artery （31 cases, 50.8% ） and dorsa pancreatic artery （14 cases, 23.0 % ） ; In 48 cases of pancreat- ic body tumors, 35 cases （72.3%） were dorsa pancreatic tumor, 9 eases （18.9%） were superior mesenteric artery, and 7 cases （14.6% ）were greater pancreatic artery; In 37 cases of pancreatic tail tumors, 29 cases （78.4 % ） were pancreatic tail artery, 14 cases （38.8%） were grater pancreatic artery, and 3 cases （8.1%） were dorsa pancreatic artery. In 61 cases of pancreatic head and neck tumors, dual artery supply was witnessed in 34 cases （55.7%）. Conclusions： Advanced pancreatic tumor feeding ar- teries are correlated with the locations of tumor mass. The feeding artery of the pancreatic head and neck tumor mostly origi- nates from pancreaticoduodenal artery, that of the pancreatic body tumor mostly originates from the dorsa pancreatic artery, and that of the pancreatic tail tumor mostly originates from the pancreatic tail artery.