胰腺囊腺癌的诊断(附36例报告)

【】1007-9424(2005)05-0509-02(36)DiagnosisofPancreaticCystadenocarcinoma(ReJortof36Cases)*****【】。1263690。BCT,52.8%77.8%,78.9%86.7%;CEA、CA19-9(E)94.4%,BCT(x216.094.18,P0.005,P0.050)。CEA、CA19-9CEA、CA19-9(62=5.14,P0.025)。XERCP,,。ECA19-9CEA。B、CTCEA、CA19-9,。【】【】R735.9【】K、,。,。1998520025126,3690,。11.1126,、、()。9032,58,17～85,51;19,25,13,33;19(11,8),、、4、7、8,71,、、21、32、18。36,9,27,27～83,55;、、6、19、11。12634,2;79,11。75.0%(27/36)。TNM[1]Ⅰ10、Ⅱ14、Ⅲ7、Ⅳ5。1.221,CEACA19-9(P0.05),2(P0.05)。36,CEACA19-9【】*(610041)【】(1969-),,,,,。11;90,3。12(n=36)(%)(n=90)(%)x2P2261.14853.30.630.05616.71820.00.190.05411.188.90.150.052158.35055.60.080.0512.81314.43.540.05513.93336.76.340.05()28.0µmol/L616.7910.00.980.0535g/L513.91415.60.060.052000U/L822.21921.10.020.05CEA20ng/ml1336.11011.110.780.05CA19-937kU/L2261.188.938.670.051.32126B、CT、ERCPX。B38,,19;88B,17。CT40,28;86CT,8。X,4。ERCP,5。(E)CEA、CA19-9(CEA20ng/ml,CA19-937kU/L),36CEA、CA19-92230,20CEACA19-9;90CEA、CA19-976,2CEA·905·20059125ChinJBasesClinGeneralSurg,Vol.12,No.5,Sep.2005CA19-9。126,27,9,8.5mm,,,、。9,4CEACA19-9,2CA19-9,1CEA。1.4126,5,7,,。9.5%(12/126)。1.52。2,BCT,52.8%77.8%,78.9%86.7%;CEACA19-9;CEA、CA19-9CEACA19-9,66.7%88.9%,(x2=5.14,P0.025);CEA、CA19-9(94.4%),BCT(x216.094.18,P0.005,P0.050)。2、BCTCEACA19-9CEA+CA19-9CEA+CA19-9CEA+CA19-9+(%)52.877.836.161.161.183.375.066.788.9*94.4,#+(%)78.986.788.992.291.194.410083.387.887.8CEA+CA19-9,*x2=5.14,P0.025;,,x2=5.26,P0.010;B,#x2=16.09,P0.005;CT,+x2=4.18,P0.0502,、。、,[2,3],62.5%[4]。,,,。XERCP,、、,;,E。CEA、CA19-9,,、,CEA、CA19-9,11.1%8.9%,,CEA、CA19-9。CEA、CA19-9,61.1%83.3%。,94.4%,87.8%,89.7%。76%[5]。,E,。B、CTCA19-9CEA,。,,,E,。①、;②,,;③X、B、CT,、,,,,,,,,。E:,[6]。5,,,。E9.5%,Wiersema[7](14%)。,,;,,。Varadarajulu[8],。1,,.[M].1.:,1996:501～5022LiBD,MinnardE,NavaH.Cysticneoplasmsofthepancreasareview[J].JLaStateMedSoc,1998;150(1):163LeBorgneJ,deCalanL,PartenskyC.Cystadenomasandcysta-denocarcinomasofthepancreas:amultiinstitutionalretrospectivestudyof398cases.FrenchSurgicalAssociation[J].AnnSurg,1999;230(2):1524,.[J].,2002;14(2):895,,.[J].,2002;22(1):296FrossardJL,AmouyalP,AmouyalG,etal.Performanceofen-dosonography-guidedfineneedleaspirationandbiopsyinthedi-agnosisofpancreaticcysticlesions[J].AmJGastroenterol,2003;98(7):15167WiersemaMJ,VilmannP,GiovanniniM,etal.Endosonogra-phy-guidedfine-needleaspirationbiopsy:diagnosticaccuracyandcomplicationassessment[J].Gastroenterology,1997;112(4):10878VaradarajuluS,EloubeidiMA.Frequencyandsignificanceofa-cuteintracystichemorrhageduringEUS-FNAofcysticlesionsofthepancreas[J].GastrointestEndosc,2004;60(4):631(2004-03-19,2004-11-30)()·015·20059125ChinJBasesClinGeneralSurg,Vol.12,No.5,Sep.2005