338例胰腺癌诊治分析

Diagnosis and treatment of 338 cases of pancreatic cancer

目的总结中国医科大学附属第一医院普外科收治的胰腺癌病人诊治情况及预后,为胰腺癌病人的临床处理提供一定依据。方法对2011年1月至2018年1月中国医科大学附属第一医院普外科收治的338例胰腺癌病人的临床资料作回顾性分析。结果 338例病人中男性213例,女性125例;年龄(59.07±10.44)岁(28～80岁);常见症状以腹痛、腹胀、黄疸、消瘦为主;CT检查阳性率96.37%,超声检查阳性率85.37%,癌抗原19-9(CA19-9)阳性率86.44%;手术治疗229例,未进行手术109例。共获得随访263例,平均生存期10.68个月,第1年生存率36.42%,第2年生存率17.21%,第3年生存率9.37%;CA19-9水平、TNM分期、伴有转移及治疗方式是影响其预后的独立危险因素。结论胰腺癌预后差,腹部CT和CA19-9临床意义较大,早期诊断与手术有助于提高生存期,改善生存质量。

Objective To investigate the diagnosis and treatment of pancreatic cancer admitted in our hospital and to provide some basis for clinical treatment of pancreatic cancer.Methods From January 2011 to January 2018,the clinical data of 338 patients with pancreatic cancer admitted at Department of General Surgery in the First Affiliated Hospital of the China Medical University were analyzed retrospectively.Results Among 338 patients,there were 213 males and 125 females with age ranged from 28 to 80 years old(59.07±10.44 years).The common symptoms were abdominal distension,jaundice and weight loss.The positive rate of CT examination,ultrasonography and CA19-9 was96.37%,85.37% and 86.44% respectively.Surgical treatment was performed on 229 cases and 109 cases were not given surgery.A total of 263 cases were followed up.The average survival time was10.68 months.The first-,second-and third-year survival rate was 36.42%,17.21% and 9.37% respectively.The prognosis was related to many factors.The level of CA19-9,TNM staging,metastasis and treatment were independent risk factors influencing prognosis.Conclusions The prognosis of pancreatic cancer is poor.The abdominal CT and CA19-9 are of great clinical significance.Early diagnosis and operation can increase survival and improve quality of life.