由于壶腹部解剖复杂,病理医师不熟悉壶腹癌的三维生长模式、缺乏标准的大体取材方法,Vater壶腹癌（以下简称为壶腹癌）TNM分期相对困难.美国抗癌联合会（the American Joint Committee on Cancer,AJCC）和国际抗癌联盟（Union for Inter...由于壶腹部解剖复杂,病理医师不熟悉壶腹癌的三维生长模式、缺乏标准的大体取材方法,Vater壶腹癌（以下简称为壶腹癌）TNM分期相对困难.美国抗癌联合会（the American Joint Committee on Cancer,AJCC）和国际抗癌联盟（Union for International Cancer Control,UICC）TNM分期系统是世界范围内评估壶腹癌预后最重要的参考.第7版TNM分期标准是2010年颁布的,2016年发布的第8版TNM分期系统的壶腹癌章节做出了较大改动,本文将结合近年来文献对这些改动进行解读,并对壶腹癌病理取材,报告内容等相关问题做一阐述.展开更多
OBJECTIVE Ampullary carcinoma is a rare disease with betterprognosis than other periampullary neoplasms. This studyinvestigated the association between clinicopathologic factors andprognosis after radical resection of...OBJECTIVE Ampullary carcinoma is a rare disease with betterprognosis than other periampullary neoplasms. This studyinvestigated the association between clinicopathologic factors andprognosis after radical resection of ampulla of Vater carcinoma.METHODS Clinical data from 105 patients who underwentradical pancreaticoduodenectomy from January 1990 to December2005 were retrospectively analyzed by the Kaplan-Meier method,log-rank test, and the Cox proportional hazard model.RESULTS The in-hospital mortality rate was 8.6%, the lymphnode metastasis rate was 37.1%, and the five-year survival ratewas 42.8%. Pancreatic involvement (P = 0.027), tumor diameter (P= 0.008), T stage (P = 0.003), TNM stage (P < 0.001), and number ofmetastatic lymph nodes (P < 0.001) were associated with prognosiswhen the univariate analysis was used. Multivariate analysisshowed that the number of lymph node metastases (P < 0.001;OR: 1.923; CI: 1.367-2.705) and tumor diameter (P = 0.03; OR: 1.432;CI: 1.035-1.981) were the independent prognostic factors.CONCLUSION The number of metastatic lymph nodes andtumor diameter are important pathologic factors predictingprognosis of ampulla of Vater carcinoma after radical resection,and lymph node dissection during the radical surgery effectivelyimproves the survival rate.展开更多
文摘由于壶腹部解剖复杂,病理医师不熟悉壶腹癌的三维生长模式、缺乏标准的大体取材方法,Vater壶腹癌（以下简称为壶腹癌）TNM分期相对困难.美国抗癌联合会（the American Joint Committee on Cancer,AJCC）和国际抗癌联盟（Union for International Cancer Control,UICC）TNM分期系统是世界范围内评估壶腹癌预后最重要的参考.第7版TNM分期标准是2010年颁布的,2016年发布的第8版TNM分期系统的壶腹癌章节做出了较大改动,本文将结合近年来文献对这些改动进行解读,并对壶腹癌病理取材,报告内容等相关问题做一阐述.
文摘OBJECTIVE Ampullary carcinoma is a rare disease with betterprognosis than other periampullary neoplasms. This studyinvestigated the association between clinicopathologic factors andprognosis after radical resection of ampulla of Vater carcinoma.METHODS Clinical data from 105 patients who underwentradical pancreaticoduodenectomy from January 1990 to December2005 were retrospectively analyzed by the Kaplan-Meier method,log-rank test, and the Cox proportional hazard model.RESULTS The in-hospital mortality rate was 8.6%, the lymphnode metastasis rate was 37.1%, and the five-year survival ratewas 42.8%. Pancreatic involvement (P = 0.027), tumor diameter (P= 0.008), T stage (P = 0.003), TNM stage (P < 0.001), and number ofmetastatic lymph nodes (P < 0.001) were associated with prognosiswhen the univariate analysis was used. Multivariate analysisshowed that the number of lymph node metastases (P < 0.001;OR: 1.923; CI: 1.367-2.705) and tumor diameter (P = 0.03; OR: 1.432;CI: 1.035-1.981) were the independent prognostic factors.CONCLUSION The number of metastatic lymph nodes andtumor diameter are important pathologic factors predictingprognosis of ampulla of Vater carcinoma after radical resection,and lymph node dissection during the radical surgery effectivelyimproves the survival rate.
