摘要
目的 比较男性与女性胰腺囊性肿瘤（PCN）的临床特征及预后差异.方法 回顾性分析解放军总医院2010年1月至2015年10月325例经术后病理证实为PCN患者的临床资料,分析男性与女性PCN患者的临床特征、实验室检查、影像学特征、治疗方式及预后.结果 325例PCN中,男104例,女221例.男性患者平均发病年龄明显大于女性[（55.0±12.7）岁与（47.9±13.4）岁,P〈0.001],肿瘤直径小于女性[（3.9±2.7）cm与（4.9 ±3.0）cm,P=0.004],差异具有统计学意义.男性患者肿瘤更易位于胰头颈部,肿瘤性质以黏液性肿瘤居多.PCN患者的1、3、5年总体生存率分别为98.5％、92.6％、87.5％,男性患者的1、3、5年生存率分别为97.8％、84.9％、77.8％,女性患者1、3、5年生存率分别为98.8％、96.5％、92.2％,女性患者的预后明显优于男性（χ^2=5.543,P=0.019）.CA19-9升高（χ^2=3.843,P=0.050）、神经侵犯（χ^2=6.250,P =0.012）、淋巴结转移（χ^2=4.529,P=0.033）是影响恶性胰腺黏液性囊性肿瘤患者预后的重要危险因素.结论 男性PCN发病率较低,且多为黏液性肿瘤,PCN恶变后预后较差,即使完整切除后,男性患者预后仍差于女性,术后仍需密切随访.
Objective To compare the clinicopathological features and prognosis of pancreatic cystic neoplasms （PCN） between male and female patients.Methods A total of 325 patients with histological confirmed PCN from January 2010 to October 2015 were enrolled.The clinicopathological features,laboratory examination,imaging features,treatment and prognosis were analyzed.Results Of the 325 patients diagnosed as PCN,104 were male and 221 were female.The average age of male patients was significantly higher than that of female patients （55.0 ± 12.7 vs 47.9 ± 13.4 years,P 〈0.001）,however,the average tumor size of male patients was smaller than that of female patients （3.9 ± 2.7 vs 4.9 ± 3.0 cm,P =0.004）.The location of PCN in male patients was predominantly located at pancreatic head and neck,and majority of male patients were mucinous cystic neoplasms.1-year,3-year and 5-year survival rates of patients with PCN were 98.5%,92.6%,and 87.5%,respectively.1-year,3-year and 5-year survival rates of male patients were 97.8%,84.9%,and 77.8%,however,those of female patients were 98.8%,96.5%,and 92.2%,respectively.Female patients had better prognosis than male patients （χ^2=5.543,P =0.019）.Elevated CA19-9 （χ^2=3.843,P =0.050）,perineuronal invasion （χ^2=6.250,P =0.012） and lymph node metastasis （χ^2=4.529,P =0.033） were important prognostic factors for malignant mucinous cystic neoplasm.Conclusions Male patients had low incidence of PCN,and were more common for mucinous cystic neoplasm.The long-term outcome of malignant PCN was poor.Even with complete resection,male patients still had worse prognosis.Close follow-up is recommended especially for male patients.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2016年第40期3222-3226,共5页
National Medical Journal of China
关键词
胰腺囊性肿瘤
恶性
预后
男性
Pancreatic cystic neoplasm
Malignant
Prognosis
Male
