【摘要】 目的 探讨胰体尾癌的诊断与外科治疗以及影响预后的因素。方法 回顾性分析我院普外科2000年1月至2007年12月间收治的95例胰体尾癌患者的临床资料。结果 胰体尾癌的主要临床表现为中上腹胀痛、腰背部疼痛、恶心呕吐和消瘦、乏力，肿瘤标志物、B超、CT、MRCP、PET-CT等检查是诊断胰体尾癌的主要方法，各有特点。本组手术切除率为37.9%(36/95)，其中根治性切除率为31.6%(30/95)，姑息性切除6例(6.3%)，姑息性旁路引流手术18例，26例仅行剖腹探查。根治性切除者生存期明显长于非根治性切除者(P<0.01)，扩大根治术又较根治术有更长的生存期。行根治性切除患者中，有神经转移、淋巴结转移或切缘残留者术后生存期较短。结论 早期诊断，提高根治切除率，才有可能延长胰体尾癌患者的生存期。手术方式的选择对患者的预后有重要意义，根治术和扩大根治术可明显延长患者术后生存期。肿瘤是否有神经转移、淋巴转移及切缘有否残留是影响根治性手术预后的重要因素。
【关键词】 胰体尾肿瘤;平均生存期;根治术;诊断;预后
Diagnosis and treatment of pancreatic body and tail carcinoma SHI Changying， SUN Yongwei， WU Tingting， et al. Department of General Surgery， Renji Hospital， Affiliated to Medical School of Shanghai Jiaotong University， Shanghai 200127
Abstract Objective To explore and discuss the diagnosis and treatment of pancreatic body and tail carcinoma and evaluate the factors influencing the prognosis after radical resection. Methods The clinical data of 95 patients with pancreatic body and tail carcinoma in Renji hospital from 2000 to 2007 were retrospectively analyzed. Results The main clinical manifestations were abdominal pain， backache， nausea and vomiting， emaciation and weakness. Tumor marker， ultrasonography， CT， MRCP were the main methods to diagnose pancreatic body and tail carcinoma and showed different features respectively. Eighty patients were treated with operation， including 30 cases of radical excision. Radical resection was associated with a longer survival period campared with drainage or laparotomy (P<0.01) and what’s more， extended radical resection had a longer survival period than radical ones. Survival period was shortened if there were factors， such as nerve invasion， lymph node metastasis and incinal margin positive existence in radical ones. Conclusion The diagnosis of pancreatic body and tail carcinoma should be combined clinical performances， laboratory tests， tumor markers and imaging examinations. Radical resection and extended radical resection pro
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