| Background:Pancreatic cancer is one of the most malignant tumors,accounting for the fourth highest mortality of malignant tumors[1].The mortality rate of carcinoma of body and tail of the pancreas is higher than that of pancreatic head carcinoma[2].Because of the special anatomical location and biological characteristics of pancreatic body-tail carcinoma,most of them had distant metastasis at the time of diagnosis.The incidence of carcinoma of body and tail of the pancreas is increasing year by year.Although there has been great progress in diagnosis and treatment in recent years,the overall prognosis of carcinoma of body and tail of the pancreas is still poor and the survival rate is low.Objective:Objective to provide clues for early diagnosis of carcinoma of body and tail of the pancreas by exploring the susceptible factors and clinical characteristics of pancreatic body tail carcinoma.Methods:From January 1,2014 to December 31,2016,the clinical data of 92 patients with carcinoma of body and tail of the pancreas diagnosed by imaging and / or pathology for the first time in our hospital and 145 patients with pancreatic head cancer diagnosed by imaging and / or pathology for the first time in our hospital were collected.Case control study was carried out.Exclusion of patients with previous history of cancer,metastatic pancreatic cancer,unknown location of pancreatic cancer,and diagnosis and treatment of pancreatic cancer in an external hospital.SPSS 21.0statistical software was used to carry out statistical analysis.The counting data were described by positive rate or composition ratio,using the ?2 test or the Fisher exact probability method;The measurement data in accordance with normal distribution were described by mean ±standard deviation and t test;The non-normal distribution data were described by median,quartile spacing and Mann-Whitney U test;P <0.05,differences had statistical significance,P < 0.01,differences had significantstatistical significance.Results:1.The primary symptoms of carcinoma of body and tail of the pancreas are abdominal distension pain,low back pain,The second is chest tightness,confusion,anorexia,edema of both lower limbs,etc,and the incidence of low back pain was13.0%,higher than that of pancreatic head cancer group(P<0.01).Pancreatic body and tail carcinoma is easily misdiagnosed as chronic gastritis,gastric ulcer,lumbar disc herniation,gastrointestinal dysfunction,etc.The total misdiagn osis rate was 29.3%(27/92),higher than that of pancreatic head carcinoma group(P < 0.05).2.In carcinoma of body and tail of the pancreas group,the incidence of new diabetes mellitus was 28.6%(18/63),the incidence of dyslipidemia was 25.0%(11/44),the incidence of cholecystolithiasis was 5.4%(5/92),lower than that of pancreatic head carcinoma group(P < 0.05).3.The values of total bilirubin(TBIL),direct bilirubin(IBIL),indirect bilirubin(DBIL),glutamic-pyruvic transaminase(ALT),glutamic-oxalacetic transaminase(AST),alkaline phosphatase(ALP),?-glutamyl transpeptidase(?-GT)and total bile acid(TBA)in carcinoma of body and tail of the pancreas group were lower than those in pancreatic head carcinoma group(P < 0.05),and albumin(ALB)was higher than that in pancreatic head carcinoma group(P < 0.01).4.The positive rate of carcinoembryonic antigen(CEA)in carcinoma of body and tail of the pancreas group was 55.3%,which was higher than that in pancreatic head carcinoma group(P < 0.01).5.Distant metastasis occurred in most patients with carcinoma of body and tail of the pancreas(75%).The most common cases were liver metastasis(50.0%),vascular infiltration(35.9%),abdominal metastasis(13.0%),and intraperitoneal metastasis(13.0%),all of them were higher than those of pancreatic head carcinoma group(P < 0.01).6.In the choice of treatment,carcinoma of body and tail of the pancreas group was given the main oral antitumor drugs(52.2%),followed by chemotherapy(17.8%),non radical operation(16.7%)and radical operation(13.3%).Compared with the group of pancreatic head carcinoma,the rate of non-radical operation was lower thanthat of the control group(P < 0.05),and the rate of chemotherapy was higher than that of the control group(P < 0.01).Conclusion:The initial symptoms of carcinoma of body and tail of the pancreas are diverse and easy to be misdiagnosed or missed.Low back pain can be used as a relatively specific clinical manifestation.Compared with pancreatic head carcinoma,carcinoma of body and tail of the pancreas accompanied with new diabetes mellitus,gallbladder stone,abnormal blood lipid incidence rate was lower;High positive rate of carcinoembryonic antigen;Liver metastasis,vascular involvement and intraperitoneal implantation metastasis are easy to occur.Most patients with carcinoma of body and tail of the pancreas have missed the opportunity of radical surgery.Oral adjunctive antineoplastic drugs are the main treatment. |
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