第二原发胰腺癌临床特征分析(英文)

Clinical features of second primary pancreatic cancer

目的 :探讨第二原发胰腺癌的临床特征。 方法 :以 96例普通原发胰腺癌作为对照 ,回顾性分析了病理确诊的 32例第二原发胰腺癌的临床特征。 结果 :32例第二原发胰腺癌 1 5例 (4 6 .9% )发生于乳腺癌、胃癌之后。性别、年龄、部位、临床症状、常规实验室检查及肿瘤标志物检测与普通进展期胰腺癌具有可比性 ,仅年龄略为提前 ,消化不良稍多 ,腹痛、黄疸比例稍降。B型超声、CT、MRI、逆行胰胆管造影诊断敏感率较普通胰腺癌高。处于Ⅰ期者仅 2例 (6 .3% )。总体半年存活率为5 0 .0 % ,较普通胰腺癌略低。病理显示 84 .4 %为腺癌 ,分化差。 结论 :第二原发胰腺癌症状更不典型 ,诊断更为滞后 ,预后更差 ,故应加强联系与第一次癌肿的早期检测手段 (如肿瘤标志物 )研究。

Objective:To study the clinical features of second primary pancreatic cancer(PC).Methods:The clinical features of 32 cases pathologically diagnosed second primary PC were retrospectively analyzed in detail,and 96 cases of common primary PC were taken as control.Results:Among 32 second primary PC patients, 15(46.9%) occurred after breast cancer or gastric cancer.Of sex,age,location of neoplasms,clinical symptoms,routine laboratory tests and assay of tumor markers,there were no significant differences between second primary PC and primary PC; only the age was a little younger than that of common PC; the percentage of dyspepsia was slightly higher;the percentages of abdominal pain and jaundice were slightly lower.The sensitivities of abdominal ultrasonography,spiral computed tomography(SCT),magnetic resonance imaging(MRI) and endoscopic retrograde cholangiopancreatography(ERCP) in diagnosis of second primary PC were higher than that of common PC.Only 2 patients(6.3%) were in stage Ⅰ.The total half year survival rate was 52.0% for second primary PC,which was lower than that of common PC.Conclusion:The symptoms of second primary PC are more atypical than that of common PC,so the diagnosis is more difficult,and the prognosis is even worse.We should pay more attention to the studies of early detection measures(such as tumor markers) associated with the first primary cancers.