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中华腔镜外科杂志(电子版) ›› 2022, Vol. 15 ›› Issue (04): 252 -256. doi: 10.3877/cma.j.issn.1674-6899.2022.04.014

综述

胰颈癌的外科诊疗进展
严力1, 常浩生2, 赵之明2,(), 陈永亮2   
  1. 1. 100853 北京,解放军总医院第一医学中心肝胆胰外科医学部;261021 潍坊,解放军陆军第八十集团军医院普通外科
    2. 100853 北京,解放军总医院第一医学中心肝胆胰外科医学部
  • 收稿日期:2022-03-28 出版日期:2022-08-30
  • 通信作者: 赵之明

The surgical progress of diagnosis and treatment of pancreatic neck cancer

Li Yan1, Haosheng Chang2, Zhiming Zhao2,(), Yongliang Chen2   

  1. 1. Faculty of Hepato-Pancreato-Biliary Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China.; Department of General Surgery, The 80th Group Military Hospital of the PLA Army, Weifang 261021, China
    2. Faculty of Hepato-Pancreato-Biliary Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
  • Received:2022-03-28 Published:2022-08-30
  • Corresponding author: Zhiming Zhao

胰腺癌是消化系统最常见的恶性肿瘤之一,具有恶性程度高、侵袭性强等特点。肿瘤生长部位不同,对于胰腺癌的临床病理特征、诊疗策略和生存预后都有着关键影响,其中胰颈癌源于其紧邻胰周重要血管的临床解剖特点,其可切除率往往较其他部位更低,肿瘤生物学行为表现侵袭性更强,因此其外科诊疗策略亦有不同。笔者基于胰颈癌的临床病理学和肿瘤生物学特征,结合胰腺癌目前的研究进展,对多学科协作团队背景下胰颈癌诊疗进展做一综述。

Pancreatic cancer is one of the most common malignant tumors of the digestive system, which has the characteristics of high malignancy and strong invasiveness. The anatomical location of tumors has a key impact on the clinicopathological characteristics, diagnosis and treatment strategies, and prognosis of pancreatic cancer. Due to the clinical anatomical characteristics of its close proximity to vital blood vessels around the pancreas, the resectable rate of pancreatic neck cancer is lower than that of pancreatic cancer in other sites, and the tumor biological behavior is more aggressive, thus its surgical diagnosis and treatment strategies are also different. Based on the clinicopathological characteristics of pancreatic neck cancer and the current research progress of pancreatic cancer, this article reviews the progress of the diagnosis and treatment of pancreatic neck cancer under the background of a multidisciplinary team.

1
Siegel RL, Miller KD, Fuchs HE, et al. Cancer Statistics, 2022[J]. CA Cancer J Clin202272(1):7-33.
2
Bilimoria KY, Bentrem DJ, Ko CY, et al. Validation of the 6th edition ajcc pancreatic cancer staging system: report from the national cancer database[J]. Cancer, 2007110(4):738-744.
3
胡建昆,周总光,杨开清.胰腺的应用解剖[J]. 世界华人消化杂志20019(7):826-829.
4
刘树伟,王永贵.胰颈的矢状断面解剖及其临床意义[J]. 中国解剖学杂志199412(2):135-137.
5
Gray H, Clemente CD. Gray’s Anatomy (30th American ed)[M]. Philadelphia: Lea&Febiger,1985,1503-1504.
6
赵振美,刘树伟,林祥涛,等.胰的冠状断层标本与磁共振对照研究[J].解剖学报200536(5):523-527.
7
Ocuin LM, Sarmiento JM, Staley CA, et al. Comparison of central and extended pancreatectomy for lesions of the pancreatic neck[J]. Ann Surg Oncol200815(8):2096-2103.
8
Strasberg SM, Sanchez LA, Hawkins WG, et al. Resection of tumors of the neck of the pancreas with venous invasion: the "whipple at the splenic artery (WATSA)" procedure[J]. J Gastrointest Surg, 201216(5):1048-1054.
9
Hirono S, Kawai M, Okada K, et al. Pancreatic neck cancer has specific and oncologic characteristics regarding portal vein invasion and lymph node metastasis[J]. Surgery2016159(2):426-440.
10
Lee M, Kwon W, Kim H, et al. The role of location of tumor in the prognosis of the pancreatic cancer[J]. Cancers(Basel)202012(8):2036.
11
Erning FN, Mackay TM, Geest LGM, et al. Association of the location of pancreatic ductal adenocarcinoma (head, body, tail) with tumor stage, treatment, and survival: a population-based analysis[J]. Acta Oncol, 201857(12): 1655-1662.
12
Honda K, Katzke VA, Husing A, et al. CA19-9 and apolipoprotein-A2 isoforms as detection markers for pancreatic cancer: a prospective evaluation[J]. Int J Cancer, 2019144(8):1877-1887.
13
Yan L, Chen YL, Su M, et al. A single-institution experience with open irreversible electroporation for locally advanced pancreatic carcinoma[J]. Chin Med J (Engl)2016129(24):2920-2925.
14
Huang X, Fan C, Zhu H, et al. Glypican-1-antibody-conjugated gd-au nanoclusters for fi/mri dual-modal targeted detection of pancreatic cancer[J]. Int J Nanomedicine, 201813:2585-2599.
15
Wang Q, Yan H, Jin Y, et al. A novel plectin/intergrin-targeted bispecific molecular probe for magnetic resonance/near-infrared imaging of pancreatic cancer[J].Biomaterials2018183:173-184.
16
Chu LC, Park S, Kawamoto S, et al. Utility of CT radiomics features in differentiation of pancreatic ductal adenocarcinoma from normal pancreatic tissue[J].AJR AM J Roentgenol2019213:349-357.
17
Chang N, Cui L, Luo Y, et al. Development and multicenter validation of a CT -based radiomics signature for discriminating histological grades of pancreatic ductal adenocarcinoma[J].Quant Imaging Med Surg202010:692-702.
18
Huang L, Jansen L, Balavarca Y, et al. Resection of pancreatic cancer in europe and usa: an international large-scale study highlighting large variations[J]. Gut, 201968(1):130-139.
19
王琛,樊勇,夏博伟. 微创时代下胰腺癌诊疗进展[J/CD].中华腔镜外科杂志(电子版)201912(5):311-316.
20
Katz MHG, Varadhachary GR, Fleming JB, et al. Serum CA 19-9 as a marker of resectability and survival in patients with potentially resectable pancreatic cancer treated with neoadjuvant chemoradiation[J].Ann Surg Oncol201017:1794-1801.
21
Maulat C, Canivet C, Touraine C, et al. A new score to predict the resectability of pancreatic adenocarcinoma: the bacap score[J]. Cancers (Basel)202012(4):783.
22
Oba A, Croce C, Hosokawa P, et al. Prognosis based definition of resectability in pancreatic cancer: a road map to new guidelines[J].Ann Surg2022275(1) : 175-181.
23
Chen Y, Tan C, Mai G, et al. Resection of pancreatic tumors involving the anterior surface of the superior mesenteric/portal veins axis: an alternative procedure to pancreaticoduodenectomy with vein resection[J].J Am Coll Surg2013217: 21-28.
24
Chen Y, Wang X, Ke N, et al. Inferior mesenteric vein serves as an alternative guide for transection of the pancreatic body during pancreaticoduodenectomy with concomitant vascular resection: a comparative study evaluating perioperative outcomes[J]. Eur J Med Res201419:42.
25
Park SY, Shin WY, Choe YM, et al. Extended distal pancreatectomy for advanced pancreatic neck cancer[J]. Korean J Hepatobiliary Pancreat Surg201418:77-83.
26
Hartwig W, Gluth A, Hinz U, et al.Total pancreatectomy for primary pancreatic neoplasms: renaissance of an unpopular operation[J].Ann Surg2015261:537-546.
27
Jegatheeswaran S, Baltatzis M, Jamdar S, et a1.Superior mesenteric artery(SMA) resection during pancreatectomy for malignant disease of the pancreas:a systematic review[J]. HPB(Oxford)201719(6):483-490.
28
Glebova NO, Hicks CW, Tosoian JJ, et al. Outcomes of arterial resection during pancreatectomy for tumor[J].J Vasc Surg, 2016, 63(3):721-729.
29
Hirano S, Kondo S, Hara T, et al. Distal pancreatectomy with en bloc celiac axis resection for locally advanced pancreatic body cancer: long-term results[J]. Ann Surg, 2007246(1):46-51.
30
Murakami Y, Nakagawa N, Kondo N, et al. Survival impact of distal pancreatectomy with en bloc celiac axis resection combined with neoadjuvant chemotherapy for borderline resectable or locally advanced pancreatic body carcinoma[J]. Pancreatology, 202121(3):564-572.
31
Nakamura T, Hirano S, Noji T, et al. Distal pancreatectomy with en bloc celiac axis resection (modified appleby procedure) for locally advanced pancreatic body cancer: a single-center review of 80 consecutive patients[J]. Ann Surg Oncol201612:23.
32
Yamamoto T, Satoi S, Kawai M, et al. Is distal pancreatectomy with en-bloc celiac axis resection effective for patients with locally advanced pancreatic ductal adenocarcinoma-multicenter surgical group study[J]. Pancreatology, 201818(1):106-113.
33
中国抗癌协会胰腺癌专业委员会.中国胰腺癌综合诊治指南(2020版)[J].中华外科杂志202159(2):81-100.
34
Zhang B, Lee GC, Qadan M, et al. Revision of pancreatic neck margins based on intraoperative frozen section analysis is associated with improved survival in patients undergoing pancreatectomy for ductal adenocarcinoma[J].Ann Surg, 2021274(2), 134-142.
35
Jang JY, Kang JS, Han YM, et al. Long-term outcomes and recurrence patterns of standard versus extended pancreatectomy for pancreatic head cancer: a multicenter prospective randomized controlled study[J].J Hepatobiliary Pancreat Sci201724(7): 426-433.
36
Dillhoff M, Pawlik TM. Role of node dissection in pancreatic tumor resection[J]. Ann Surg Oncol202128(4):2374-2381.
37
Versteijne E, Suker M, Groothuis K, et al. Preoperative chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer: results of the dutch randomized phase Ⅲ preopanc trial[J]. J Clin Oncol202038(16):1763-1773.
38
Tempero MA, Malafa MP, Al-Hawary M, et al. Pancreatic adenocarcinoma, version 2.2021, nccn clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw202119(4):439-457.
39
Van RS, Van VE, Klompmaker S, et al. Evaluation of adjuvant chemotherapy in patients with resected pancreatic cancer after neoadjuvant folfirinox treatment[J]. JAMA Oncol20206:1733-1740.
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