摘要
目的 鉴别胰腺囊性肿瘤良恶性诊断的影响因素.方法 回顾性分析北京协和医院1984年1月至2008年6月126例胰腺囊性肿瘤的病例数据、资料.根据病变组织学特征将病人分为恶性与良性两组,评估各种术前因素对恶性胰腺囊肿诊断的预测价值.结果 126例胰腺囊性肿瘤病人中,37例为恶性,89例为良性.单变量分析显示病人性别、症状（黄疸和体重下降）、血清CA199升高以及肿瘤内存在突起、实性成分或分隔等影像学特征在良恶性病变间存在显著差异.多因素分析显示病人性别和肿瘤的影像学特征是恶性肿瘤的独立预测因素.结论 病人性别,肿瘤大小、临床症状（黄疸或消瘦）、影像学特征（肿瘤内有乳头状突起、实性成分或分隔）和血清CA199是诊断胰腺恶性囊性肿瘤的重要指标,临床可据此确定是否手术治疗.
Objective To determine the effecting factors for diagnosis of binign or malignant in cystic lesions of pancreas（CLP）.Methods One hundred twenty-six patients undergoing operations for CLP or suspected CLP in this hospital from January 1984 to June 2008 were reviewed.Patients were divided into two groups according to lesion＇s histological features after operation.The predictive effect of various preoperative factors on the malignant potential of CLP was evaluated.Results One hundred twenty-six patients underwent operations for suspected pancreatic cystic neoplasms.There were 89 benign and 37 malignant CLPs.The univariate analysis showed that gender, clinical symptoms（jaundice and weight loss）, elevated serum CA199, and presence of one or more of three morphologic features such as solid component, nodule or septation were significantly different between benign and malignant cystic neoplasm of pancreas.The multivariate analysis indicated that imaging features and gender were independent predictors of malignancy.Conclusion In patients with suspected pancreatic cystic neoplasms, elevated serum CA199, clinical symptoms（jaundice and weight loss）and presence of suspicious morphologic features on imaging are predictors of malignant potential of CLP.Patients with a high likelihood of a potentially malignant or malignant lesion based on these three factors should undergo operation without additional investigations.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2010年第11期831-834,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
胰腺
囊性占位
恶性肿瘤
乳突状突起
肿瘤标志物
Pancreas
Cystic space-occupying lesion
Malignancy
Sudden milk like pro-tuberance
Tumor marker
