对50例连续行胰远端切除术联合腹腔轴切除术胰腺体癌胰腺外神经丛浸润情况进行详细分析。

Hepato-gastroenterology Pub Date : 2015-03-01
Takahiro Tsuchikawa, Satoshi Hirano, Toru Nakamura, Keisuke Okamura, Eiji Tamoto, Soichi Murakami, Yo Kurashima, Yuma Ebihara, Toshiaki Shichinohe
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引用次数: 0

摘要

背景/目的:晚期胰体癌常伴有胰外神经丛(PL)浸润,是判断患者预后的不良指标之一。本研究旨在揭示胰腺体癌向腹腔动脉(CA)和肠系膜上动脉(SMA)根部浸润的进展,并探讨其诊断准确性的相关性。方法:对50例连续行远端胰切除术合并腹腔轴切除术(DP-CAR)的患者的标本进行病理分析,确定其侵袭方向。CT影像的诊断准确性也进行了探讨。结果:50例患者中有37例(74%)在CHA、SPA、CA和SMA周围出现PL侵犯。在诊断准确性方面,SPA、CHA、CA和SMA对PL侵犯的阳性预测值分别为35%、36%、43%和81%。在21例患者和23例患者中,分别有13例和6例患者伴有PL侵犯CA周围。结论:胰体癌常伴癌旁浸润,在诊断准确率较低的情况下,DP-CAR可能是一种可行的手术,可增加R0切除的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Detailed analysis of extra-pancreatic nerve plexus invasion in pancreatic body carcinoma analyzed by 50 consecutive series of distal pancreatectomy with en-bloc celiac axis resection.

Background/aims: Advanced pancreatic body carcinoma frequently accompany extra-pancreatic nerve plexus (PL) invasion, one of the poor indicator of patient prognosis. The present study aimed to reveal the progress of the PL invasion from cancer of the pancreas body toward the root of the celiac artery (CA) and superior mesenteric artery (SMA) followed by investigation of the relevance of diagnostic accuracy.

Methodology: Resected specimens from 50 consecutive patients who underwent distal pancreatectomy with en bloc celiac axis resection (DP-CAR) were pathologically analyzed for the direction of PL invasion. Diagnostic accuracy on CT imaging were also investigated.

Results: Thirty seven of the 50 patients (74%) were positive for PL invasion around the CHA, SPA, CA and SMA. In terms of the diagnostic accuracy, positive predictive values for the PL invasion were 35%, 36%, 43% and 81% for the SPA, CHA, CA and SMA, respectively. Among 21 patients and 23 patients with PL invasion around CHA and SPA, 13 and 6 patients also accompanied PL invasion around CA, respectively.

Conclusions: Carcinoma of the pancreatic body is found to frequently accompany PL invasion around CA. Under the limitation of low diagnostic accuracy, DP-CAR might be feasible operation that increases the possibility of R0 resection.

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来源期刊
Hepato-gastroenterology
Hepato-gastroenterology 医学-外科
自引率
0.00%
发文量
1
审稿时长
1.9 months
期刊介绍: Hepato-Gastroenterology has been discontinued as of 2015. Extremely limited quantities of back issues in print available for sale.
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