| Objectives Epidemiological characteristics and possible prognostic factors of pancreatic carcinosarcoma were reported and analyzed to provide case support to the clinical diagnosis and treatment of this disease.Methods Provided by the Medical Records Room,medical records of patients admitted in Affiliated Tumor Hospital of Guangxi Medical University and diagnosed as pancreatic tumor were searched through Hospital Information Management System(HIS)and screened for the final case data.At the same time,domestic and foreign literature on pancreatic carcinosarcoma in both English and Chinese was collected by searching related databases,and information was extracted according to reference inclusion/exclusion criteria.SPSS17.0 was used for analysis,and Kaplan-Meier estimator was used for survival analysis.Results Among the 356 medical records(provided by Medical Records Room of Affliated Tumor Hospital of Guangxi Medical University)of inpatients admitted between January 1,2010 to December 31,2016 and diagnosed as pancreatic malignant tumor,1 case of pancreatic carcinosarcoma was collected with complete medical history,related laboratory tests,conformed pathology results as well as treatment and follow-up;meanwhile,data wassearched in databases such as CBM,VIP,CNKI,WanFang,PubMed,Web of Science,Medline and Springer Link from their establishment to February 2017 and extracted according to reference inclusion/exclusion criteria.Recall ratio was increased by tracing back literature and searching manually.Obtained were 8 Chinese reports,9 medical records,22 English articles and clinical data for 31 cases.At last,41 cases were included for analysis,results as follows:1.Clinical features: male-female ratio for patients with pancreatic carcinosarcoma was 0.782:1,age of onset between 24-82 years of age,median age 64 and the peak incidence was 61-80 years of age.Clinical manifestations were nonspecific.Common clinical symptoms were epigastric discomfort(20cases,48.78%)and jaundice(11 cases,26.82%).Most tumors are located in the head of pancreas(25 cases,69.44%),sized 2.0-19.0 cm,average size 6.01 ±3.01cm;CT scan often reveals cystic and solid mass.CA19-9 level may decrease after operation,and the increase may indicate tumor recurrence.2.Pathology features.It consists of two or more independent tumor compositions.Immunohistochemistry is different for each composition,indicating their various sources.In cancer cells,expression of keratin is positive while that of Vimentin is negative;in sarcoma cells,expression of keratin is negative while that of Vimentin is positive.3.Prognostic factors analysis: univariate analysis showed that the patient's gender,age,tumor location and size,staging and CA19-9 level were not relevant to the prognosis(P > 0.05).Only the survival time difference between patients at early(I & II)stages undergoing surgical treatment alone and whose receiving combined treatment of surgery and adjuvant chemotherapy is statistically significant(P = 0.042).Conclusion1.Pancreatic carcinosarcoma is a rare tumor,more common in women with peak age of onset 61-80 years of age.2.Pancreatic carcinosarcoma mostly occurs at the pancreatic head,and main symptoms are epigastric discomfort and jaundice.3.CT scan for pancreatic carcinosarcoma often reveals cystic and solid mass in pancreas.4.Tumor marker CA19-9 may be regarded as an indicator for postoperative recurrence of pancreatic carcinosarcoma.5.Surgery is an important method for treating pancreatic carcinosarcoma,and postoperative adjuvant chemotherapy can extend the survival time. |
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