胰头癌及壶腹周围癌84例诊断分析

Combined methods for periampullary cancer and pancreatic head carcinoma diagnosis（ analysis of 84 cases）

目的探索有效的胰头癌及壶腹周围癌的诊断方法。方法回顾性分析2009年1月至2011年6月收治的84例胰头癌及壶腹周围癌的临床资料。结果胰头癌组癌抗原（CA）19—9表达水平高于其它组，与壶腹癌组比较，差异有统计学意义（P〈0．05）；十二指肠癌组的癌胚抗原（CEA）、CA125表达水平较高，与胰头癌组比较，差异有统计学意义（P〈0．05）。彩色超声、CT、MRI这3项影像学检查中，CT的诊断符合率高于彩色超声，且差异有统计学意义（P〈0．05）。CA19—9联合彩色超声对胰头癌及壶腹周围癌诊断的检出率为81．0％（68／84），较单独检测CA19—9和单独彩色超声检查检出率均有明显提高；CA19-9联合CT检查对胰头癌及壶腹周围癌联合诊断的检出率为92．9％（78／84），较单独CA19—9和CT检查检出率有明显提高。结论早期胰头癌及壶腹周围癌诊断困难，而联合应用不同检查方法可以提高正确诊断率。

Objective To explore the effective method in diagnosis of periampullary cancer and pancreatic head carcinoma. Methods A retrospective study was accomplished on the 84 cases of peri- ampullary cancer or pancreatic head carcinoma hospitalized from January 2009 to June 2011. Results CAI 9-9 expression in pancreatic cancer patients was higher than other groups, compared with the amp- ullary cancer group, the difference was significant （P 〈 0. 1）5 ） ; CEA, CA125 expression in duodenal cancer patients were higher than other groups, compared with the pancreatic cancer group, the differ- ence was significant （P〈0. 05）;Among examinations of color Doppler ultrasound,CT and MRI, the difference of diagnosis rat between ultrasound and CT was statistically significant （x2 = 10. 286,P〈 0. 05）. The diagnostic accuracy for periampullary cancer and pancreatic head carcinoma was 81. 0%（68/84）, when CA19-9 combined with ultrasound,compared with CA19-9 detection rate 61.9 % （52/ B4） and ultrasound detection rate of 64 % （54/84）; The diagnostic accuracy for periampullary cancer and pancreatic head carcinoma was 92. 9 % （78/84）, when CA19-9 combined with CT, compared with CA19-9 detection rate 61.9 % （52/84） and CT detection rate 86 % （72/84）. Conclusion Early diagnosis for periampullary cancer and pancreatic head carcinoma is difficult, but combined application of different inspection method can improve the diagnostic accuracy.