淋巴结转移及肿瘤病理学特点对胰头癌预后的影响

目的：探讨淋巴结转移及肿瘤病理学特点对胰头癌预后的影响。方法：对53例胰头癌行胰十二指肠切除和不同范围淋巴结清扫的临床资料进行回顾性分析。结果：胰头癌最常出现转移的淋巴结是13（58.5%）、12（49%）、8（32.1%）、14（18.9%）站淋巴结,低分化组的中位生存期和复发转移的中位时间分别是12.6个月、10.3个月;中高分化组分别是18.3个月、14.7个月。结论：Whipple手术＋第一站淋巴结清扫可能是治疗胰头癌较为合理的手术方式,单纯扩大手术范围并不能有效改善患者预后。

The influence of the lymph node metastasis and pathological charactersitics in prognosis of the head of pancreatic cancer

Objective：To investigate the influence of the lymph node metastasis and pathological charactersitics in prognosis of the head of pancreatic cancer. Methods： A total of 53 cases with carcinoma in head of pancreas were analyzed retrospectively, who were underwent pancreaticoduodenectomy and different extent of regional lymphadenectomy. Results： The most common lymph nodes metastasis were found in No. 13 （ 58.5% ）, No. 12 （49%） , No. 8 （32.1%） and No. 14 （18.9%）. The middle time of survival and recurrency for poorly differentiated group were 12.6 months,10. 3 months;for well differentiated group were 18.3 months, 14.7 months. Conclusion： It may be more reasonable that pancreaticoduodenectomy in combination with lymphadenectomy of the first group of lymph nodes is performed for carcinoma in head of pancreas, the extended lymphadenectomy is not beneficial in prognosis of carcinoma in head of pancreas.