外分泌胰臟癌之臨床分析

Clinical Features of Exocrine Pancreatic Cancer

10.6200/TCMJ.2013.10.4.02

邱信瑋(Hsin-Wei Chiu)；陳冠仰(Kuan-Yang Chen)；王鐘貴(Chung-Kwe Wang)；楊旻達(Ming-Da Young)；林志陵(Chi-Ling Lin)；林聰蓉(Tsung-Jung Lin)；劉文良(Wen-Liang Liu)；廖麗瑛(Li-Ying Liao)

外分泌胰臟癌 ； 新診斷糖尿病 ； 急性胰臟炎 ； exocrine pancreatic cancer ； newly diagnosed DM ； acute pancreatitis

北市醫學雜誌

10卷4期（2013 / 12 / 30）

309 - 316

英文

目的：在台灣，胰臟外分泌癌正逐年上升；除了小於兩公分的腫瘤可切除而有較佳存活率外，其餘患者的預後都非常的差；因此找出胰臟癌的危險因子，分析出胰臟癌的高危險群並加以做癌症篩檢是十分重要的。方法：收集了本院自2005一月到2009年十二月共八十七位胰臟外分泌癌的病人。三十九位病人為病理組織證實胰臟癌，其餘的四十八位（55%）則由電腦斷層或核磁共振等影像學檢查加上腫瘤標記所診斷。結果：87名病患中男性有49位，女性有38位，男女比為1.3：1。平均年紀為68.8±13.4歲。39名患者（44.8%）有糖尿病史，在這些糖尿病患者中有4位為在診斷胰臟癌之前一年內新診斷的糖尿病。有5名患者（5.7%）在診斷胰臟癌之前有急性胰臟炎的病史。結論：在台灣，胰臟外分泌癌多發生在老年人並以男性稍多，所有患者診斷年紀皆在四十歲以上。新診斷的糖尿病、胰臟炎病史及肥胖為潛在的危險因子。之後應該對這些因子做進一步的分析研究。

Objective: Exocrine pancreas cancer (EPC) is a rising cancer in Taiwan. The prognosis of EPC is very poor since early diagnosis is difficult and only patients with small, less than 2 cm, and resectable tumor have better survival. Therefore, it is important to identify the risk factors of EPC in order to define the high risk group for further cancer screening. Methods: Medical records of 87 consecutive EPC cases diagnosed during Jan 2005 and Dec 2009 were reviewed. Thirty nine (44.83%) of them were histology proven. The other 48 (55%) were diagnosed by image modalities such as CT scan and MRI plus tumor markers and disease progression. Results: Our sample consisted 49 males and 38 female, and the mean age was 68.8±13.4 years. Thirty nine (44.8%) of them had DM. Among them, 4 (10.3%) had DM diagnosed within one year and 5 (5.7%) had a history of acute pancreatitis. Conclusions: 1. EPC was common among elderlies, with mild male preponderance in our study. All patients were over 40 years old. 2. DM, especially the newly diagnosed DM, pancreatitis and obesity were potential risk factors. Further case control study and prospective follow up study is warranted.