【摘要】 目的分析总结300例胰腺癌患者的临床特点,评估相关肿瘤标记物的价值,以提高对胰腺癌的认识。方法回顾性分析1995年10月—2003年10月北京协和医院的300例胰腺癌病例。结果①临床表现消瘦(226例,75.3%)、腹痛(199例,66.3%)、食欲不振(153例,51.0%)、黄疸(150例,50.0%)、腹胀(132例,44.0%)、腰背痛(54例,18.0%)、腹泻(43例,14.3%)、黑便(23例,7.7%);②肿瘤标记物的敏感性CA19-9为77.5%,CA50为66.0%,CA242为48.3%,CEA为29.7%,CA19-9联合CA50、CA242、CEA的敏感性为86.0%;③CA19-9的滴度与能否行根治手术的比率及是否伴有远处转移相关(P<0.05),与淋巴结转移、胰胆管病变无关;④CA19-9切割值在37 U/mL时,受胆红素水平影响且呈显著相关性,而当切割值在150、240和500 U/mL时两者无相关性;⑤本组行根治性手术者30.7%,姑息性手术者27.3%,非手术治疗占42%。结论CA19-9升高应注意胆红素对其的影响。应熟悉胰腺癌的临床特点,提高对于胰腺癌的认识,尽早诊断。更多还原

【Abstract】 Objective To analyze and summarize the clinical characteristics and to evaluate the laboratory tests and therapeutic methods of pancreatic carcinoma,so as to improve the understanding pancreatic carcinoma.MethodsThree hundreds cases of pancreatic carcinoma were collected during 1995—2003 in PUMCH.Results ①The clinical systoms included weight loss(75.3%),abdominal pain(66.3%),anorexia(51.0%),jaundice(50.0%),abdominal distention(44.0%),back pain(18.0%),diarrhea(14.3%) and melena(7.7%).②The sensitivities of tumor markers to diagnose pancreatic cancer were 77.5% of CA19-9,66.0% of CA50,48.3% of CA242 and 29.7% of CEA.If CA19-9 combined with CA50,CA242 and CEA,its sensitivity was increased up to 86.0%.③The titer value of CA19-9 was significantly related with radical operation ratio(P<0.05),but it was not related to metastasis of lymph node and the tumor location either in pancreatic or bile duct.④CA19-9 had significantly influenced by bilirubin at 37 U/mL,but it didn’t at 150,240 and 500 U/mL.⑤ The therapeutics used were radical operation(30.7%),palliative operation(27.3%) and non-operation(42%).Conclusion The titer value ofCA19-9 may be interfered with bilirubin.It is important for early diagnose to find clinical characteristics of pancreatic carcinoma and to apply correctly diagnostic methods.更多还原