| Objective To analyze the clinical and pathological features of 95 cases pancreatic cancer of Tianjin Medical University General Hospital, explore the impact factors of tumor recurrence, metastasis and patient survival. Immunohistochemical method to study the expression of S100A4 protein in pancreatic cancer, analyze the the role of S100A4 in the occurrence, development, metastasis and prognosis of pancreatic cancer.Methodl.The clinical data of the Pancreatic cancer administrated during 1999-2009 was collected. The age, sex, tumor location, tumor size, symptoms, serum tumor marker (CA199,cA242,CEA), imaging and endoscopy examination results (CT,B-us, Duodenoscope, E-us), morphological characteristics, pathological characteristics, neurovascular invasion, location recurrence, metastasis,clinical stage were analyzed.2. Immunohistochemical S-P method was used to detecte the expression of S100A4 protein in pancreatic cancer paraffin samples. The expression level of S100A4 protein was analyzed with the clinical and pathological Characteristic.Results1.95 cases of pancreatic cancer patients with a median age of 57 years,the incidence peak concentrated in the 50-70 years old. The male to female ratio was 1.64:1. Epidemiological investigation showed, smoking (≥20 pcs/day×10 years) 12 cases, alcohol consumption (≥100g×10 years)21 cases.5 cases with a history of biliary diseases,17 cases associated with history of diabetes, chronic pancreatitis 2 cases. The most common symptoms were abdominal pain (67.4%), jaundice (44.2%), epigastric fullness, anorexia (51.6%), weight loss (58.9%),s kin itching (15.8%), gastrointestinal tract symptoms (54.7%), stool color lighter (32.6%). The majority of pancreatic carcinoma located in the pancreatic head (64.2%), the size of tumor from 1.5×1.8cm to 18cm×12cm. CA19-9 was the most important serum tumor markers, and its level gradually increased with the development of tumor. CT has the highest accuracy rate in the diagnosis of pancreatic cancer of all of the imaging and endoscopic examination (95.1%), it can predict the resectability of pancreatic cancer. Single-factor analysis supported the clinical stage, distant metastasis, complete resection, tumor type, postoperative chemotherapy was significantly correlated with prognosis. Compared with that the first five years, there was no significant difference about the survival of patients who take the radical surgical treatment in the last five years.2. Immunohistochemical S-P method detected high expression of S100A4 in pancreatic cancer (66.7%). And S100A4 is closely related with the lymph node metastasis, Neoplasm Invasiveness and TNM staging. S100A4 is useful in evaluating the out come of patients with pancreatic cancer.Conclusion1. Weight loss, abdominal pain, jaundice, abdominal distention are the most common but non-specific clinical manifestations for pancreatic cancer. It is difficult for early diagnosis and curing this tumor.2. Combined detection of CA19-9, CA242, CEA can improve the positive rate of diagnosis for pancreatic cancer, CT has higher value in the diagnosis of pancreatic cancer among the imaging method, it can predict the resectability of pancreatic cancer.3. The standardpriciple of therapy is radical excision, It can extend the survival time and increase the 1 year or 5 year survival rate. There was no significant difference about the survival in patients who take the radical surgical treatment in the last five years. Palliative surgery could not result the long term survival, but can advances the life quality.4. Clinical stage, distant metastasis, complete resection, postoperative chemotherapy, tumor type was significantly correlated with prognosis.5. S100A4 is closely related with the lymph node metastasis, neoplasm invasiveness and TNM staging; S100A4 is useful in evaluating the out come of patients with closely related with pancreatic cancer. |
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