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Objective To investigate the diagnosis and treatment of tumor of the head of pancreas(THP). Methods The clinical data of 277 cases of THP were restrospectively reviewed. All patients were diagnosed by US,CT, gastroenteric barium meal and /or operation. A comparison was made in 80 cases , who underwent pancreatoduodenectomy were divided into group A(41 patients operated during1982-1995) and group B(39 patients operated after January,1996) . Results 194 patients underwent surgical treatment,including explore laparotomy in 28,bilioenterostomy or T tube drainage in 86,pancreatoduodenectomy(PTD) in 80.Among 80 cases treated with PTD, the operation time,blood loss volume and blood transfusion volume during operation, and serious postoperative complication occurring rate in group A were significantly higher than those in group B(all P 0.05 ).The follow up results were as follows:the average survival time was (4.07 ?1.80) months in patients with bile external drainage, and (8.28 ?2.31) months in hepatojejunostomy,(P
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Objective To study and evaluate the diagnostic and differencial diagnostic value of detection of human telomerase reverse transcriptase(hTERT) mRNA and telomerase activity in pancreatic juice of (pancreatic) cancer(PC) .Methods hTERT mRNA expression and telomerase activity in pancreatic juice in 24 cases of (pancreatic) cancer and 14 cases of chronic pancreatitis(CP) were detected and compared.Results Expression of hTERT mRNA was detected in 87 .5% (21/24) of PC cases and 21.4%(3/14) of CP cases(P
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Objective To investigate the expression of 5-LOX in pancreatic cancer tissue and the relationship between 5-LOX expression and expression of VEGF.Methods The expression of 5-LOXmRNA,(VEGFmRNA) in 35 pancreatic cancer fresh tissue samples were detected by semi-quantitive reverse(transcriptase)-polymerase chain reaction method.Results Expression of 5-LOXmRNA,VEGFmRNA in(pancreatic) cancer tissue were 74.3%,60% respectively,and the expression was correlated to the with(clinical) stages of the tumor;also expression of VEGFmRNA was correlated to the differentiation of the tumor.Expression of 5-LOXmRNA and VEGFmRNA were synergetic in pancreatic cancer(P
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0.05).There was correlation between the expression of 5-LOX and TNM stages.The expression of 5-LOX in stages III~IV of pancreatic cancer was markedly higher than that in stages I~II of pancreatic cancer(P
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9scores). Results Fifty-five of fifty-seven cases with CT between 0～6 scores,which considered to be resected,underwent tumor resection . The accuracy of prediction of CT was 96.5%. Conclusions Preoperative CT scord could accurately predict the resectability and difficulty of pancreatic cancer.
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Objective To study the early diagnosis and the prognosis of carcinoma of the head of pancreas(CHP) and to determine the sensitivity of various detecting methods. Methods Data of preoperative diagnosis and prognosis in 22 patients with early stage of CHP and 168 patients with advanced CHP treated in our department in recent 15 years were retrospectively analyzed and compared. Results The early stage of CHP revealed no specific symptom. In early stage of CHP,the diagnlstic rate was 88.9%, detecting rate of cancer cells in pancreatic juice with ERCP was 88.4%, The sensitivity of needling cytologic examination during operation was 91.7%,the resection rate was 90.9%, 3years survival rate was 36.4%.Those were significantly higher than those in advanced CHP. Conclusions B mode ultrasonography and CT are the first choice of diagnosis for early stage of CHP. ERCP and selective celiac artery angiography can promote diagnostic rate. Searching carcinoma cells in pancreatic juice collected by ERCP and needling cytologic examination during operation can further improve the early diagnostic rate.In patients with early stage of CHP,the resection rate and post operation cure rate are significantly higher than those in patients with advanced CHP.