【摘要】 目的探讨胰头癌肿瘤细胞的淋巴结转移模式及胰头癌扩大切除术的适用范围。方法按日本胰腺协会(Japanese Pancreas Society,JPS)制定的胰腺癌研究通则对126例胰头癌扩大切除标本行淋巴结分组(1~18组)并计数,其中包括3例有肝转移的胰腺癌病例,分析淋巴结各组的转移频率、肿瘤大小、分化程度与淋巴结转移的相关性,淋巴结转移和肝转移间的关系。结果 126例胰头癌扩大切除标本中88例有淋巴结转移,移频率由高到低排列前3位的依次是13组、14组和17组。15例有16组淋巴结转移的病例中,14例同时伴有13组、14组或17组淋巴结转移,另1例仅有16组淋巴结转移;3例有肝转移的病例不伴有16组淋巴结转移。淋巴结转移率与肿瘤分化程度呈负相关;淋巴结转移率与肿瘤大小及肝脏转移无明显相关性。结论淋巴结的广泛转移和早期发生远处转移是导致胰腺癌高度恶性的原因,无远处转移的患者才能从胰十二指肠扩大切除术中获益。更多还原

【Abstract】 Objective To investigate the pattern of lymph node involvement in carcinoma of head of pancreas in order to determine the applicability of extended pancreaticoduodenectomy. Methods Lymph nodes obtained from the extended pancreaticoduodenectomy were grouped(No.1-18) according to the Japanese Pancreas Society(JPS) General Rules for the Study of Pancreas Cancer.The frequency of each involved lymph node group was calculated,including 3 cases of liver metastases.The correlations between the lymph node involvement and the tumor differentiation,tumor size and liver metastases were investigated.Results Eighty-eight of 128 cases underwent extended pancreaticoduodenectomy had lymph node involved.The 3 most frequently involved lymph node groups were No.13,14 and 17.Fourteen of 15 cases with group lymph node metastasis of group 16 involved had lymph node metastasis of group 13,14 or 17,and the left one case had lymph node metastasis of group 16 alone.The frequency was inverse correlated with tumor differentiation,and there was no statistical correlations between lymph node involvement and tumor size or liver metastases. Conclusions The extensive lymph node involvement and earliest distant metastases leads to the high malignancy of pancreatic carcinoma.Only the patients without distant metastasis could benefit from the pancreaticoduodenectomy with extended resection of involved lymph nodes.更多还原