胰头癌和壶腹癌的淋巴结转移及病理特点分析

Pathological Characteristics and Lymph Node Metastasis of Carcinoma of the Head of the Pancreas and Ampullary Carcinoma

目的:探讨胰头癌和壶腹癌的淋巴结转移及病理特点。方法:回顾性分析201例胰头癌和壶腹癌根治手术后的淋巴结转移及病理特点,χ2检验分析淋巴结转移与病理因素的相关性。结果:201例胰头癌和壶腹癌行胰十二指肠切除术,淋巴结转移率分别为32.65%(16/49),30.92%(47/152),其转移淋巴结累及部位基本相同,其中88.89%(32/36)单个淋巴结转移位于胰十二指肠周围。χ2检验显示壶腹癌淋巴结转移相关的病理因素有:肿瘤直径(P=0.002),肿瘤分化程度(P=0.012),十二指肠壁浸润(P=0.008),T分期(P=0.000),胰腺受侵(P=0.005),胰头癌与上述病理因素无关,但神经浸润比例高。结论:胰头癌的淋巴结转移及病理特点与壶腹癌有所不同,手术方式的应有所区别,胰头癌应行扩大根治性手术切除。

Objective：T o invetigate the pathological characteristiese and bymph node metastasis of caareinoma of the head of the pancreas and ampullary careionoma.Methods：The patbological characteristics and lymph node metastasis of 201 patients with earcinoran of the panereas and anpullary ereinoma were retrospectively analyzed and the chi-square test was condueted to analyze the relationship between lymph node metastasis and pathological factors.Results：A total of 201 cases with carcinoma of the head of the pancreas and ampullay carcionma underwent pancreaticoduodenectonry.The rate of lymph mode metastasis was 32.65%（16/49） in cases of carcinoma of the bead of the panereas and 30.92%（47/152） in cases of ampullary careinoma.and the location of ymph node metastases was similar with.88.89%（32/36）of the cases with solitary lymph mode metasasis found in the pancreaticoduodenal region.The chi-square thest revealed that lymph mode metastsis of ampullary carcinoma was associated with the size of tumors（P=0.002）,histological didfferentiation （P=0.002）,duodenal infiltration （P=0.008）,T stage （P=0.000）,and pancreatic infiltration（P=0.005）,but careinoma of bead of the pancras had no relation to the above patbological factors.However,the rate of neural infilration was high in cases of carcinoma of the head of the pancreas.Conclusion：Pathologieal characteristics and lymph node metastasis of earcinoma of the head of the pancreas are different from those of ampulay careinorma,so f follws that the tratments should be different from each other,Enlarged radieal exeision is needed for careinoma of the bead of the pancreas.