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MSCT对胰腺癌TNM分期预测和可切除性评估的临床运用进展
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- Author:
- No author available
- Journal Title:
- Chinese Journal of Pancreatology
- Issue:
- 3
- DOI:
- 10.3760/cma.j.issn.1674-1935.2018.03.017
- Key Word:
- No keyword available
Abstract： 胰腺癌(pancreatic carcinoma,PC)是一种起病隐匿,恶性度高,预后差,生存率低的消化系统恶性肿瘤,由于其临床缺乏特异性,故早期诊断和治疗均较困难[1].近年来胰腺肿瘤外科迅速发展,手术治疗成为PC唯一有效的治疗手段[2],但是术后复发率仍高达80％,可获得根治性切除患者不足15％,术后5年生存率约5％,预后并无突破性改善[3-4].术后肿瘤复发的主要原因是术前常规影像学对阳性淋巴结和胰周神经浸润(perineural invasion,PNI)的诊断不足,导致手术切除不彻底[5].PC术后淋巴结转移率和PNI分别高达56％～78.6％和50.0％ ～ 100％,即便在肿块直径≤2 cm的小胰癌,两者的发生率也高达约50％[6-7].由此可见,降低PC术后复发率的关键在于早期诊断、术前准确的临床分期以及多学科联合诊治.CT诊断PC的敏感性、特异性分别为91％、90％,成为PC诊断、分期以及判断肿瘤可切除性的首选检查方法[8-9].现就多层螺旋CT(multislice CT,MSCT)对PC的临床分期、可切除性评估现状做一综述.
- [1]陈哲,郭君武,冯广森,等.螺旋CT对胰腺癌腹主动脉旁淋巴结转移的评价[J].2009,(3).
- [2]张太平,曹喆,赵玉沛.《2015年美国国立综合癌症网络胰腺癌临床实践指南（V2版）》外科相关部分解读[J].2015,(5).
- [3]汪炳瑞,邱伟华.胰腺癌嗜神经侵袭的解剖和分子生物学研究进展[J].2014,(4).
- [4]王建承,陈希,费健,等.胰腺癌不同分期方法的比较研究[J].2009,(5).
- [5]袁敏,江旭,吕桃珍,等.多层螺旋CT对胰腺癌血管侵犯的可切除性评价标准探讨[J].2008,(5).
- [6]周振宇,王捷.2015年NCCN胰腺癌指南诊疗更新解读[J].2015,(4).
- [7]张太平,肖剑春,赵玉沛.NCCN胰腺癌外科治疗指南解读[J].2010,(5).
- [8]薛华丹,刘炜,王沄,等.多层螺旋CT对胰腺癌转移淋巴结的诊断能力初步分析[J].2008,(12).
- [9]李晓青(译),钱家鸣(审校).《2015年美国国立综合癌症网络胰腺癌临床实践指南（V2版）》更新要点及临床路径[J].2015,(5).
- [10]Gnant M,Schima W,Schueller G,etc.Multidetector CT of pancreas: effects of contrast material flow rate and individualized scan delay on enhancement of pancreas and tumor contrast.[J].2006,241(2).
- [11]赵平.胰腺癌[M].2006.
- [12]Rowley D,Anderson M,Wang Y,etc.Enhanced survival in perineural invasion of pancreatic cancer: an in vitro approach.[J].2007,38(2).
- [13]质检出版社.胰腺癌诊断[S].2011.
- [14]Roche CJ,Hughes ML,Garvey CJ,etc.CT and pathologic assessment of prospective nodal staging in patients with ductal adenocarcinoma of the head of the pancreas.[J].2003,180(2).
- [15]McGovern PC,Cheng SL,Tublin ME,etc.Effect of injection rate of contrast medium on pancreatic and hepatic helical CT.[J].1999,210(1).
- [16]Margaret A, Tempero,J Pablo, Arnoletti,Stephen W, Behrman,etc.Pancreatic Adenocarcinoma, version 2.2012: featured updates to the NCCN Guidelines.[J].2012,10(6).
- [17]Margaret A, Tempero,Mokenge P, Malafa,Stephen W, Behrman,etc.Pancreatic adenocarcinoma, version 2.2014: featured updates to the NCCN guidelines.[J].2014,12(8).
- [18]E. M.Loyer,C. L.David,R. A.Dubrow,etc.Vascular involvement in pancreatic adenocarcinoma: reassessment by thin-section CT[J].1996,21(3).
- [19]Uemoto S,Isaji S,Kawarada Y.Classification of pancreatic cancer: comparison of Japanese and UICC classifications.[J].2004,28(3).
- [20]Kadota M,Yamashita Y,Hirota M,etc.Vascular encasement by pancreatic cancer: correlation of CT findings with surgical and pathologic results.[J].2001,25(3).
- [21]D S, Lu,H A, Reber,R M, Krasny,etc.Local staging of pancreatic cancer: criteria for unresectability of major vessels as revealed by pancreatic-phase, thin-section helical CT.[J].1997,168(6).