胰腺转移癌10例诊断及治疗

Diagnosis and treatment of metastatic pancreatic tumor with a case series of 10 patients

目的探讨胰腺转移癌的诊断及治疗方法。方法对1997年7月至2007年7月中国医科大学附属第一医院收治的10例胰腺转移癌进行回顾性分析。结果原发肿瘤为肺癌3例、结肠癌2例、胃癌2例、肾癌2例、鼻咽癌1例。胰腺转移距发现原发肿瘤时间间隔平均40个月（0—192个月）。10例转移灶均位于胰腺头颈部，单发9例，多发1例，肿瘤最大径平均3．03cm。主要临床表现为腹痛、腹胀、厌食、黄疸等。行胰十二指肠切除术2例，胰动脉灌注化疗1例，经皮经肝胆管内支架置入术1例，全身化疗2例，放疗1例，3例未行进一步治疗。7例获得随访，生存时间2—44个月，平均10．6个月。结论胰腺转移癌临床少见，表现无特异性，应根据具体情况选择合理的治疗措施，对可切除者应积极手术治疗。

Objective To describe the diagnosis and treatment of metastatic pancreatic cancer. Methods The clinical data of 10 cases of metastatic pancreatic tumor in the first affiliated hospital of China Medical University from July 1997 to July 2007 were analyzed retrospectively. Results The etiologies of primary tumors were lung cancer （ n = 3 ） , colonic carcinoma （ n = 2 ） , stomach cancer （ n = 2 ） , renal cell carcinoma （ n = 2 ）, nasopharyngeal carcinoma （ n = 1 ）. The median interval between the diagnosis of primary tumor and pancreatic metastases was 40 months （range： 0 - 192 months）. All the metastases were located in the pancreatic head and neck, and solitary metastasis was detected in one case, while other 9 cases were multiple metastases. The mean maximum tumor size was 3.03 cm. The main clinical manifestations were abdominal pain, bloating, anorexia and jaundice. 2 cases underwent pancreaticoduodenectomy, 1 case underwent arterial pancreatic perfusion chemotherapy, 1 case underwent percutaneous biliary stenting and 2 cases received systematic chemotherapy, 1 case received radiotherapy, 3 patients did not accept any therapy. 7 patients were followed-up, the median survival was 10.6 months （range： 2 -44 months）. Conclusions Metastatic pancreatic cancer was rare and the clinical manifestation was non-specific. Individuaized treatment should be selected on a case-by-case basis. Aggressive surgical resection should be offered to some selected patients.