摘要
目的探讨介入化疗对胰头癌淋巴结转移的影响。方法回顾性分析2006年12月至2007年7月复旦大学胰腺病研究所入选的50例可切除性胰头癌患者的临床资料，按术前是否接受介入化疗分为两组：化疗组（25例）术前先接受介入化疗1次，再行手术；非化疗组（25例）直接行手术治疗。采用手术显微镜法检出胰腺癌根治切除标本中的淋巴结，常规HE染色判断淋巴结有无肿瘤转移，对HE染色无转移的淋巴结再行细胞角蛋白（AE1／AE3）免疫组织化学染色检测有无肿瘤微转移存在。采用χ^2检验分析数据。结果两组术后并发症发生率和住院时间无明显差别，1、2年生存率两组比较差异也无统计学意义（χ^2=0．12，2．88，P〉0．05）。化疗组有11例患者存在淋巴结转移，淋巴结阳性检出率为7．1％（52／734）；非化疗组有15例淋巴结转移，阳性率为22．1％（118／532），两组比较差异有统计学意义（χ^2=60．01，P〈0．05）。两组各有10例淋巴结HE染色阴性标本进行细胞角蛋白（AE1／AE3）染色检测，共发现53枚淋巴结微转移，化疗组为9．4％（30／319），非化疗组为9．1％（23／252），两组比较差异无统计学意义（χ^2=0．01，P〉0．05）。结论术前介入化疗有助于减少可切除胰头癌淋巴结转移的发生，降低肿瘤临床分期，有望改善预后。
Objective To evaluate the efficacy of preoperative regional intra-arterial chemotherapy （RIAC） in the treatment of resectable pancreatic head carcinoma. Methods The clinical data of 50 patients with resectable pancreatic head carcinoma who had been admitted to the Research Institute of Pancreatic Diseases of Fudan University from December 2006 to July 2007 were retrospectively analyzed. Patients were randomly divided into 2 groups （ n = 25 in each group） ： patients in group A were treated with preoperative RIAC followed by regional pancreaticoduodenectomy, and patients in group B were treated with surgical procedure routinely. The lymphatic metastases in the 50 specimens of pancreatic head carcinoma were detected by histological examination with hematoxylin and eosin （HE） staining, and lymphatic micrometastases were detected by immunohistochemical method with staining of cytokeratin AE1/AE3 in 10 specimens with negative HE staining of the lymph nodes in each group. Results There was no significant difference in the incidence of complications, the length of hospital stay and the 1-, 2-year survival rates between the 2 groups （χ^2 =0. 12, 2.88, P 〉0.05）. The incidence of positive lymph node metastasis in group A was 7.1% （52/734） , which was significantly higher than 22.1% （118/532） in group B （χ^2= 60.01, P 〈 0.05）. The incidence of lymphatic micrometastasis was 9.4% （30/319） in group A, and 9.1% （23/252） in group B, with no statistical difference between the 2 groups （χ^2 = 0.01, P 〉 0.05）. Conclusions Preoperative RIAC is helpful in improving the prognosis of patients with resectable pancreatic head carcinoma by reducing the incidence of lymphatic metastasis and decreasing tumor stage.
出处
《中华消化外科杂志》
CAS
CSCD
2009年第4期262-264,共3页
Chinese Journal of Digestive Surgery
基金
卫生部临床重点学科项目
上海市优秀学科带头人计划（08411954300）
关键词
胰腺肿瘤
淋巴结转移
微转移
术前化疗
Pancreatic neoplasms
Lymphatic metastasis
Micrometastasis
Preoperative chemotherapy
