青年胰腺恶性肿瘤33例临床病理分析

目的 探讨青年胰腺恶性肿瘤（pancreatic malignant tumor,PMT）的临床病理表现,以提高其诊治水平.方法 回顾33例青年PMT的临床病理资料,结合文献综合分析.结果 33例PMT中,实性假乳头状瘤10例,导管腺癌8例,内分泌肿瘤7例,黏液性囊腺癌4例,导管内乳头状黏液癌3例,淋巴瘤1例;TNM分期：Ⅰ期13例,Ⅱ期6例,Ⅲ期6例,Ⅳ期8例.临床表现以腹痛、腹胀、腹部包块、食欲减退等为主,4例内分泌肿瘤出现血糖增高等内分泌症状,10例出现皮肤黄染.手术治疗26例,其中根治性手术21例.随访9～ 33个月,14例死亡,17例存活,2例失访.结论 青年胰腺恶性肿瘤早期多无特殊症状,且预后不良,应重视对青年胰腺恶性肿瘤的早期诊治.

Clinical and pathological analysis of youthful pancreatic malignant tumor in 33 cases

Objective To explore the clinical and pathological characters of youthful pancreatic malignant tumor （PMT） and to improve diagnostic and therapeutic level.Methods The clinical and pathological data of 33 cases of youthful PMT combined with literatures were analyzed retrospectively.Results Among 33 cases,there were l0 cases of solid pseudopapillary tumors of pancreas,8 cases of ductal adenocarcinomaes,7 cases of endocrine tumors,4 cases of mucinous cystadeno carcinoma,3 cases of intraductal papillary mucious carcinoma and 1 case of lymphoma.The pathological stage of TNM：13 cases in stage Ⅰ,6 cases in stage Ⅱ,6 cases in stage Ⅲ,8 cases in stage Ⅳ; the main clinical symptom were abdominal pain,abdominal distension,abdominal mass,appetite decrease.Four cases of endocrine tumors showed endocrine symptom such as the rise of blood sugar,10 cases accompanied by jaundice.26 cases accepted operation,and 21 cases accepted radical operation,31 cases were followed up from 9 to 33 months.14 cases died,17 cases were alive and 2 cases were lost.Conclusion Most youthful PMT show no specific symptom in early phase while with bad prognosis; the early diagnosis and treatment of youthful PMT deserve for great attention.