腹胰和背胰源性胰头癌的临床及影像特征分析

Clinical and Imaging Features of Pancreatic Head Carcinoma Arising from The Dorsal Pancreas and The Ventral Pancreas

目的探讨腹胰及背胰源性胰头癌的临床及影像学特征,并分析二者之间的差异,更好地指导临床工作。方法回顾性分析119例经外科手术病理证实为胰头导管腺癌的患者,根据CT横断位静脉期图像上胰头癌的位置分为3组,即腹胰组(ventral pancreas group,V组)、背胰组(dorsal pancreas group,D组)及两者均受累组(ventral and dorsal pancreas group,VD组),所有患者均行CT增强扫描,主要分析三组的临床指标及影像学特征。结果三组患者比较,性别、年龄、实验室检查以及肿瘤对十二指肠、神经、静脉侵犯、淋巴结转移均无明显差异。放射痛更常见于VD组。V组的存活率高于D组及VD V组患者肿瘤最大径线明显小于D组及VD组。三组肿瘤对动脉侵犯、主胰管扩张差异有统计学意义(P=0.021,0.001)。结论胰头癌由于胚胎发育的差异,导致肿瘤大小、对周围结构侵犯及患者的预后有所不同。

Objective To investigate the Clinical and imaging features of pancreatic head carcinoma arising from the dorsal pancreas and the ventral pancreas,and analyze the differences between them,so as to better guide the clinical work.Methods One hundred and nineteen patients with pancreatic head cancer confirmed by surgery and pathology were analyzed retrospectively.According to the location of pancreatic head cancer on venous CT transverse images,they were divided into three groups,,namely ventral pancreas group(Group V),dorsal pancreas group(Group D)and ventral and dorsal pancreas group(Group VD).All patients underwent CT enhanced scanning and surgical treatment.Results There were no significant differences in gender,age,laboratory examination,tumor invasion to duodenum,nerve and vein and lymph node metastasis among the three groups.Radiation pain was more common in VD group.The survival rate of group V was higher than that of group D and VD.The maximum diameter of tumor in group V was significantly smaller than that in group D and VD.There were significant differences in arterial invasion and main pancreatic duct dilatation among the three groups(P=0.021,0.001).Conclusion Due to the difference of embryonic development,the tumor size,invasion of surrounding structures and prognosis of patients with pancreatic head cancer are different.