以急性胰腺炎起病的胰腺癌患者的临床特征分析

Analysis of clinical characteristics of pancreatic cancer patients with acute pancreatitis

目的探讨以急性胰腺炎(AP)起病的胰腺癌(PC)患者的临床特征。方法回顾性分析2009年9月1日至2019年9月30日宁夏医科大学总医院收治的34例以AP起病的PC患者(病例组)的临床资料,选取同期单纯PC患者(单纯PC组)及AP患者(AP组)为对照。收集及分析患者入院时一般临床资料,血清淀粉酶、结合胆红素、CA199、CEA,腹部B超,腹部增强CT,内镜逆行性胰胆管造影(ERCP)等检查血清学和影像学特征。结果病例组血清淀粉酶较单纯PC组明显升高(P<0.01),而AP组血淀粉酶较病例组更高(P<0.05);病例组CA199、CEA、结合胆红素较AP组明显升高(P<0.05)。影像学检查方面,病例组胰管扩张、肝内外胆管扩张等特点与单纯PC组比较,差异均无统计学意义(P>0.05),而病例组胰管扩张、肝内外胆管扩张与AP组比较,差异有统计学意义(P<0.01)。结论以AP起病的PC患者的临床症状反复,血清学检查易出现血清淀粉酶、CA199、结合胆红素的升高,影像学检查易出现胰管扩张和肝内外胆管扩张。

Objective To investigate the clinical characteristics of the pancreatic cancer(PC)patients with the onset of acute pancreatitis(AP).Methods A retrospective analysis of the clinical data of 34 PC patients(the case group)with the onset of AP admitted to the General Hospital of Ningxia Medical University from September 1,2009 to September 30,2019 was performed.The patients with the PC(the PC group)and AP(the AP group)in the same period were selected as the two control groups.The patients of the general clinical data,blood amylase,conjugated bilirubin,CA199,CEA,abdominal ultrasound,abdominal enhanced CT,endoscopic retrograde cholangiopancreatography(ERCP)and other laboratory and imaging tests at the time of admission were analyzed.Results The blood amylase was significantly increased in the case group when compared with the PC group(P<0.01);the blood amylase in the AP group was higher than that in the case group(P<0.05).The CA199,CEA and conjugated bilirubin in the case group were significantly higher than those in the AP group(P<0.05).There was no difference between the imaging examinations of the case group and the simple PC group in the characteristics of pancreatic duct dilatation and intra-and extrahepatic bile duct dilatation,while the difference between the imaging examinations of the case group and the AP group was statistically significant in pancreatic duct dilatation and intra-and extrahepatic bile duct dilatation(P<0.01).Conclusion The clinical symptoms of the PC patients with the onset of AP are easily recurrent.The serum amylase,CA199,and conjugated bilirubin are prone to increase in the serological examination,and double-tube sign is prone to appear in the imaging examination.