摘要
目的了解血清甲胎蛋白（AFP）升高胰腺癌患者的临床病理特征、有效治疗措施和预后。方法检索中文数据库CNKI、万方、维普和英文数据库PUBMED、EMBASE，纳入相关临床研究或病例报道，总结其临床病理特征、预后等。结果共纳入24篇文献报道的28例血清AFP升高的胰腺癌患者。经统计，AFP升高的胰腺癌易发生于中老年男性。大部分患者在就诊时已处于中晚期，并且肝转移率高。病理类型以腺泡细胞癌为主，但不一定符合肝样癌的病理诊断。早期患者仍以手术切除为主，中晚期采用综合治疗。病理诊断符合胰腺肝样癌的患者对治疗措施的敏感性可能与肝细胞肝癌相似。AFP是判断疗效的重要指标。目前尚无对照研究比较血清AFP升高胰腺癌与AFP正常胰腺癌肝转移发生率及生存方面的差异，但从研究的统计数据看，并未显示出更差的预后。结论血清AFP升高胰腺癌患者的预后、有效治疗措施以及AFP异质体表达情况尚无定论，还需进一步的基础及临床研究。动态检测AFP及其异质体对这种类型胰腺癌的诊断、疗效、预后的判断有重要意义。
Objective To study the clinicopathologic characteristics, the optimal therapy and prognosis of patients with pancreatic carcinoma with elevated serum alpha-fetoprotein （AFP）. Methods CNKI, Wanfang database, VIP Database for Chinese Technical Periodicals, PUBMED and EMBASE were searched. Studies which met the inclusion criteria were evaluated. Results 24 reports were found which included 28 patients with pancreatic carcinoma with elevated serum AFP. The carcinoma was characterized clinically by a predilection for older male. The majority of patients had metastases at the time of diagnosis, especially liver metastases. Histopathologically, not all tumors were hepatoid carcinoma, and acinar cell carcinoma was most common. Surgical resection was the optimal treatment for patients at an early stage. Combined therapies were used on patients at an advanced stage. Patients with hepatoid carcinoma of the pancreas might be sensitive to treatment similarly to hepatocellular carcinoma. In AFP-producing pancreatic carcinoma, serum AFP level was a useful marker for diagnosis and evaluation of therapeutic response and recurrence. However, there were no sufficient evidence to support whether pancreatic carcinoma with elevated serum AFP was associated with a higher frequency of liver metastasis and poor survival. Conclusions Further studies are needed to identify the prognosis and the effective therapies for the AFP expression variance of pancreatic carci noma with elevated serum AFP. Detecting AFP and variants of AFP are important for the early diagnosis of pancreatic carcinoma with elevated serum AFP, and increase in therapeutic response and prognosis.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2013年第6期420-424,共5页
Chinese Journal of Hepatobiliary Surgery
关键词
胰腺癌
甲胎蛋白
文献计量学
Pancreatic carcinoma
alpha Fetoproteins
Bibliometrics
