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胰腺黏液性囊性肿瘤的临床特征及恶变的相关因素分析

Clinical analysis and prognosis factors of malignancy in the patients with mucinous cystic neoplasms of the pancreas

摘要:

目的:探讨胰腺黏液性囊性肿瘤(MCN)的临床病理特点及其发生恶变的相关预后因素。方法:回顾性分析2008年1月至2018年12月复旦大学附属中山医院胰腺肿瘤外科收治的及多中心胰腺囊性肿瘤数据库收录的347例经术后病理学检查结果证实为胰腺MCN患者的临床及病理学资料。其中资料来自复旦大学附属中山医院99例,来自多中心胰腺囊性肿瘤数据库248例。男性50例(14.4%),女性297例(85.6%);平均年龄48.6岁(范围:24~77岁)。根据2010年WHO胰腺肿瘤的命名及分类,对347例胰腺MCN患者资料进行回顾性病理学诊断。根据回顾性病理学诊断结果将患者分为良性病变组(包括黏液性囊腺瘤及其伴低、中级别异型增生)和恶性病变组(包括黏液性囊腺瘤伴高级别异型增生或浸润癌)。收集统计两组患者术前临床病理学及影像学特征,采用单因素和Logistic回归分析研究MCN发生恶变的相关预后因素。结果:347例患者中,24例为恶性病变,其中男性7例,女性17例。单因素分析结果显示,两组患者的年龄、性别、甲胎蛋白、CA19-9、CA125、肿瘤最大径及肿瘤部位的差异有统计学意义( P值均<0.05)。Logistic回归分析结果显示,术前肿瘤最大径为MCN发生恶变的独立预后因素( OR=1.023,95 % CI:1.002~1.045, P=0.035)。 结论:年龄、性别、CEA、CA19-9、CA125、肿瘤最大径及肿瘤部位是MCN恶性病变的重要特征,其中术前肿瘤最大径是MCN发生恶变的独立预后因素。

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abstracts:

Objective:To examine clinic pathological features of mucinous cystic neoplasms (MCN) of the pancreas and explore the prognosis factors associated with malignant transformation of MCN of the pancreas.Methods:This multicenter retrospective study included all patients with pancreatic MCN underwent surgery at Department of Pancreatic Surgery, Zhongshan Hospital of Fudan University between January 2008 and December 2018 and patients with MCN who confirmed by postoperative pathology from Multicenter Pancreatic Cystic Tumor Database. There were 50 males (14.4%) and 297 females (85.6%) and the mean age was 48.6 years (range: 24-77 years). According to the pathological results, all patients were divided into benign lesion group (including MCN and which associated with low/medium grade dysplasia) and malignant lesion group (including MCN with high-grade dysplasia or invasive carcinoma) . The preoperative clinical pathology and imaging features of the two groups were analyzed, and the risk factors associated with malignant transformation of MCN were statistically analyzed.Results:This multicenter retrospective study included 347 patients. Twenty-four of the 347 patients were malignant, including 7 males and 17 females. Univariate analysis showed that age, gender, carcino-embryonic antigen (CEA) , CA19-9, CA125, tumor maximum diameter, and tumor location were remarkably different in the two groups ( P<0.05) . Logistic regression analysis found that the preoperative tumor maximum diameter ( OR=1.023, 95 % CI: 1.002-1.045, P=0.035) was an independent risk factor for MCN malignant transformation. Conclusions:Age, gender, CEA, CA19-9, CA125, tumor maximum diameter, and tumor location are important features of MCN malignant lesions.The maximum diameter of the preoperative tumor is an independent risk factor for MCN malignant transformation.

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作者: 李婉菱 [1] 徐亚东 [1] 韩序 [1] 吴文川 [1] 楼文晖 [1] 中华外科青年医师学术研究社胰腺外科研究组 [2]
第一作者: 李婉菱
期刊: 《中华外科杂志》2020年58卷3期 225-229页 MEDLINEISTICPKUCSCD
栏目名称: 论著
DOI: 10.3760/cma.j.issn.0529-5815.2020.03.011
发布时间: 2021-09-26
基金项目:
国家自然科学基金 上海申康医院发展中心临床科技创新项目 National Natural Science Foundation of China Clinical Innovation Found from Shen Kang Hospital Development Center
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