摘要
目的:研究胰腺导管腺癌癌旁正常胰腺组织和合并慢性胰腺炎组织中各级PanIN的发生率及与临床病理学指标间的关系。方法:对航天中心医院和北京大学第三医院1994年1月至2006年12月间外科切除的36例胰腺导管腺癌标本进行回顾性研究,比较研究标本中癌旁正常胰腺组织和合并慢性胰腺炎组织中PanIN的发生情况,并与临床病理学指标进行相关性分析。结果:36例标本中共有13例存在PanIN病变,发生率为36.1%。其中,癌旁合并慢性胰腺炎组织PanIN的发生率(57.1%)明显高于癌旁正常胰腺组织(22.7%)(P<0.05);癌旁合并慢性胰腺炎组织中高级别PanIN发生率(35.7%)明显高于癌旁正常胰腺组织(4.5%)(P<0.05),PanIN-3仅在癌旁慢性胰腺炎组织中见到。在不同性别、不同分化程度及不同临床分期间PanIN的发生率均未见明显差异;CA199阳性组与阴性组中PanIN的发生率有明显差异(P<0.01)。CEA、CA125阳性组与阴性组PanIN的发生率无明显差异。结论:胰腺导管腺癌癌旁正常胰腺组织和癌旁合并慢性胰腺炎组织中PanIN的发生率逐渐增加,程度逐渐加重,支持慢性胰腺炎是向胰腺癌发展过程中的重要形态学改变。
Objective： To evaluate the features of pancreatic intraepithelial neoplasia （ PanIN ） in the vicinity of pancreatic ductal adenocarcinoma coexisting with normal pancreas and chronic pancreatitis tissues. Methods： Thirty-six patients of pancreatic ductal adenocarcinoma were retrospectively analysed. Pancreatic samples, which were surgically removed, were stained with hematoxylin-eosin for histological analysis. The specimens were evaluated blind by 2 pathologists for the presence of the fol- lowing histology： normal ducts, reactive hyperplasia, PanIN-1 A, PanIN-1B, PanIN-2, and PanIN-3, and adenocarcinoma. The correlatlonship between pancreatic intraepithelial neoplasia and clinicopathological parameters were analyzed. Results： PanIN lesions were found in 36. 1% （13/36） of pancreatic samples. PanIN lesions in vicinity of pancreatic ductal adenocarcinoma coexisting with chronic pancreatitis tissues（ 57. 1% ） was significantly higher than that in the vicinity of pancreatic ductal adenocarcinoma coexisting with nortnal pancreas tissues （ 22. 7% ） （ P 〈 0. 05 ）. Higher grade PanIN lesions in the vicinity of pancreatic ductal adenocarcinoma coexisting with chronic pancreatitis tissues （35.7%）, was significantly higher than that in vicinity of pancreatic ductal adenocarcinoma coexisting with normal pancreas tissues （4. 5% ） （ P 〈 0. 05 ）. PanIN-3 lesions were only seen in chronic pancreatitis tissues. There were no significant differences of PanIN positive rates between male and female patients, among the patients with different differentiations, or different clinic stages. As for tumor biomarkers, PanIN positive rate in CA199 positive patients was higher than that in CA199 negative patients （P 〈 0. 01 ）. No significant differences were found between CEA or CA125 negative and positive group. Conclusion： Chronic pancreatitis is an important morphological change in pancreatic cancer carcinogenesis.
出处
《中国医药导刊》
2007年第4期340-343,共4页
Chinese Journal of Medicinal Guide
关键词
胰腺导管腺癌
慢性胰腺炎
胰腺导管上皮内瘤变
Pancreatic ductal adenocarcinoma
Chronic pancreatitis
Pancreatic intraepithelial neoplasia
