胰腺癌并肝转移的临床病理学特点分析

Analysis of clinicopathological characteristics of pancreatic tumor with liver metastasis

对345例胰腺癌患者中68例经手术、病理及影像诊断学证明为肝转移的胰腺癌患者,进行临床病理学资料分析。40岁以下者肝转移率13.80%。同期>40岁者肝转移率21.10%,两组差异有统计学意义,P=0.037。全胰腺癌,肝转移率22.60%,与胰头、颈部、体及胰尾比较差异有统计学意义,P=0.005。高中分化癌与低分化癌两组肝转移率分别为8.65%和55.96%,两组差异有统计学意义,P=0.05。有、无肝转移的血管受侵率分别为44.10%和30.30%,两组差异有统计学意义,P=0.003。有淋巴结转移的胰腺癌组肝转移率为23.50%,无淋巴结转移的胰腺癌组肝转移率为18.10%,两组差异有统计学意义,P=0.033。胰腺癌局限在胰内者,肝转移率10.59%,胰腺癌侵及胰腺周围者,肝转移率32.00%,两组比较差异有统计学意义,P=0.005。初步研究结果提示,胰腺癌肝转移与胰周血管受侵、淋巴结转移及病理分化程度密切相关。

The 68 patients among 345 patients with pancreatic tumor were confirmed to metastasize to liver. The liver metastasis rate in patients who were not elder than 40-year-old was 13.80 %. The patients elder than 40-year-old the rate was 21.10%, and there was a significant difference between them （P=0. 037）. The rate of liver metastasis in total pancreatic tumor was 22.60%, which was significantly different from that in head, neck, body or tail of pan- creatic tumor. The liver metastasis rates of well and poorly differentiated tumors were 8.65 % and 55.96 % respectively,P=0. 005. Vessel invasion rate of tumor with liver metastasis was much higher than that of one without liver metastasis, P=0. 003. The rate of pancreatic tumor with lymph nodes metastasis was 23. 50 %, on the contrary, the rate was 18. 10% in patients without metastasis, P=0. 033. Pancreatic tumor cells merely existed in pancreatic tissue, the of metastasis rate was 10.59%, otherwise, the rate was 32.00 % when pancreatic surrounding tissue was involved much more tumor cells,P=0. 005. The primary study showed that pancreatic tumor with liver metastasis was closely related to the vessel invasion, lymph nodes metastasis, and differential pathological level.