不同时期胰腺癌易感因素分析与比较

目的　分析胰腺癌患者易感因素 ,以期能确认胰腺癌危险因素。方法　采用回顾性分析的方法 ,分析 1985年 10月～ 1991年 11月 (78例 )及 1995年 10月～ 2 0 0 1年 8月 (194例 )胰腺癌病例。结果　胰腺癌的发病率有逐年增高趋势 ;患者发病年龄以中老年为主 ,男性多见 ,且发病人数呈上升趋势 ;胰腺癌的易感因素依次为吸烟 (33.1% )、饮酒 (2 1.7% )、糖尿病 (11.8% )及慢性胰腺炎 (4.8% )等。1995～ 2 0 0 1年间患者有吸烟 (36 .6 % )、饮酒 (2 4 .7% )、糖尿病 (14 .9% )等病史者较 1985～ 1991年间有增加趋势 ,其中仅糖尿病 (3.8% )增加比率差异有显著性 ;随着吸烟量及年限增加 ,胰腺癌发病率有增加趋势 ;糖尿病胰腺癌组和非糖尿病胰腺癌组相比 ,肿瘤大小、部位、肿瘤切除率差异无显著性 ,但糖尿病组以高中分化腺癌为主 ,非糖尿病组低分化腺癌患者较多 ,两组之间相比差异有显著性 (P <0 .0 5 )。结论　吸烟、吸烟量与时间的长短与胰腺癌发生直接相关 ,合并糖尿病的胰腺癌者高分化腺癌比例明显高于未合并糖尿病者。胰腺癌的易感因素近期较以往亦增加。

Analysis and comparison of the predisposing factors of 272 cases with pancreatic carcinoma in different stages

Objective To identify the possible risk factors for pancreatic carcinoma by analyzing and comparing the predisposing factors of pancreatic carcinoma patients. Methods A total of 272 pancreatic carcinoma cases during Oct. 1985- Nov. 1991 and Oct. 1995-Aug. 2001 periods were retrospectively reviewed. Results The morbidity of pancreatic neoplasma tends to increase. Pancreatic neoplasma occurred more frequently in middle-aged and elder patients with a male preponderance and the prevalence rate of male patients had the tendency to increase. The predisposing factors were smoking( 33.1% ), alcohol( 21.7% ), diabetes mellitus( 11.8% ), chronic pancreatitis( 4.8% ), etc. The ratios of smoking ,alcohol and diabetes mellitus were 36.6% , 24.7% and 14.9% in 1995-2001, which were more than that in 1985-1991. However, only the increment of the ratio of diabetes mellitus ( 3.8% )had statistically significance. The morbidity of pancreatic neoplasma tends to increase with the increasing of the amount and duration of smoking. There was no significant difference in the size, location as well as the resectability of tumors between patients with and without diabetes mellitus. Well and moderate-differentiated adenocarcinoma were the most common pathological findings in patients with pancreatic carcinoma complicated with diabetes, while poorly differentiated adenocarcinoma was the major pathological findings in patients without diabetes. The difference between these two groups was statistically significant ( P <0.05 ). Conclusions The quantity and duration of smoking was directly proportional to the morbidity of pancreatic carcinoma. Well-differentiated adenocarcinoma is more prevalent in patients with diabetes mellitus than patients without it. The predisposing factors of pancreatic carcinoma in the recent period have increased compare to that in the past.