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[Clinical characteristics of metastasis-induced acute pancreatitis in patients with lung cancer].

[临床特点转移诱导急性胰腺炎患者肺癌.

  • 影响因子:0
  • DOI:10.3760/cma.j.issn.0376-2491.2020.06.009
  • 作者列表:"Xiong YY","Xu Y","Zhao Y","Sun H","Bai XY","Wu D","Qian JM
  • 发表时间:2020-02-18
Abstract

:Objective: To analyze the clinical features and prognosis of lung cancer patients with metastasis-induced acute pancreatitis (MIAP), and to provide clues for early diagnosis. Methods: The characteristics and prognosis of 8 patients with MIAP in lung cancer admitted to Peking Union Medical College Hospital from January 2002 to September 2019 were retrospectively analyzed and were compared with non-tumor-induced AP. Results: Sevencases(7/8) were Mild AP, one (1/8) was Severe AP. Four patients (4/8) presented with AP as the reporting sign and lung cancer was not diagnosed until (112±36) days after the onset of AP. Clinical manifestations included abdominal pain (8/8), weight loss (4/8), nausea and vomiting (2/8), and jaundice (1/8). Stages of lung cancer were all Ⅳ.Histopathology proved that seven cases (7/8) were small cell lung cancer, and one case (1/8) was poorly differentiated adenocarcinoma. The median survival time was 11 months. Compared with non-tumor-induced AP, lung cancer patients with MIAP were older[(62±9) vs (48±15), P=0.018], the incidence of primary pancreatic duct dilatation (37.5% vs 3.1%, P=0.004) and abdominal lymphadenopathy (37.5% vs 6.3%, P=0.017) were higher; the level of hemoglobin [105.3±15.6) g/L vs (147.9±24.8) g/L, P<0.001] and hematocrit [(31.4±5.3) vs (42.5±6.1), P<0.001] were lower. Conclusions: Patientswith MIAP in lung cancer had poor outcome and unspecific symptoms. Old age, anemia, main pancreatic duct dilatation and abdominal lymphadenopathy are diagnostic clues that merit clinical attention. :目的: 分析肺癌转移相关性急性胰腺炎(MIAP)患者的临床特征及预后,为临床早期诊断提供线索。 方法: 回顾性分析2002年1月至2019年9月北京协和医院收治的8例肺癌MIAP患者病例特点及转归,并与非肿瘤所致急性胰腺炎(AP)进行比较。 结果: 7例(7/8)为轻症AP,1例(1/8)为重症AP。4例(4/8)以AP为首发表现,自AP起病至肺癌确诊平均时间为(112±36)d。临床表现以腹痛(8/8)为主,其次为消瘦(4/8)、恶心呕吐(2/8)、梗阻性黄疸(1/8)等。肺癌分期均为Ⅳ期,7例(7/8)为小细胞肺癌,1例(1/8)为低分化腺癌。中位生存期11个月。与非肿瘤所致AP对比,肺癌MIAP患者年龄更大[(62±9)岁比(48±15)岁,P=0.018)],主胰管扩张(37.5%比3.1%,P=0.004)和腹腔淋巴结肿大(37.5%比6.3%,P=0.017)发生率更高;血红蛋白[(105.3±15.6)g/L比(147.9±24.8)g/L,P<0.001)]和红细胞压积(31.4±5.3比42.5±6.1,P<0.001)更低。 结论: 肺癌MIAP预后较差,症状不特异。老年、贫血、主胰管扩张和腹腔淋巴结肿大是其诊断线索,诊疗中应予以重视。.

摘要

目的: 分析肺癌转移所致急性胰腺炎 (MIAP) 患者的临床特点及预后,为早期诊断提供线索。方法: 回顾性分析 2002 年 1 月至 2019 年 9 月北京协和医院收治的 8 例肺癌MIAP患者的特点及预后,并与非肿瘤诱发AP进行比较。结果: Sevencases(7/8) 为轻度AP,1 例 (1/8) 为重度AP。4 例 (4/8) 患者以AP为报告征象,直到AP发病后 (112 ± 36) d才确诊为肺癌。临床表现包括腹痛 (8/8) 、体重减轻 (4/8) 、恶心呕吐 (2/8) 和黄疸 (1/8)。肺癌分期均为 Ⅳ 期,病理证实小细胞肺癌 7 例 (7/8),低分化腺癌 1 例 (1/8)。中位生存时间为 11 个月。与非肿瘤诱导的AP相比,发生MIAP的肺癌患者年龄较大 [(62 ± 9) vs (48 ± 15),P = 0.018],原发性胰管扩张 (37.5% vs 3.1%,P = 0.004) 和腹腔淋巴结肿大 (37.5% vs 6.3%,P = 0.017) 的发生率较高; 血红蛋白水平 [105.3 ± 15.6] g/L vs (147.9 ± 24.8) g/L,P<0.001] 和红细胞压积 [(31.4 ± 5.3) vs (42.5 ± 6.1),P<0.001] 较低。结论: MIAP肺癌患者预后差,症状不明确。高龄、贫血、主胰管扩张和腹部淋巴结肿大是值得临床重视的诊断线索。 : 目的: 分析肺癌转移相关性急性胰腺炎(MIAP)患者的临床特征及预后,为临床早期诊断提供线索。方法: 回顾分析 2002 年 1 月至 2019 年 9 月北京协商和医院治疗的 8 例肺癌患者病情点滴及转归,并与非肿瘤所致急性肠炎进行比较。结果: 7 例(7/8)为轻度症状,1 例(1/8)为重度症状。4 例(4/8)以首次表现为主,自起病至肺癌诊断平均时间为(112 ± 36)d。临床表现腹泻 (8/8)为主,其次为消瘦(4/8)、恶心呕吐(2/8)、 (1/8)等。肺癌分期均为 ⅳ 期,7 例(7/8)为小细胞肺癌,1 例(1/8)为小细胞肺癌。中期生存期 11 个月。与非肿瘤患者相比,肺癌患者年龄更大[(62 ± 9) 比(48 ± 15)岁,P = 0.018)],主要扩张(37.5% 比 3.1%,P = 0.004)和腹腔淋巴瘤大(37.5% 比 6.3%,P = 0.017) 生产率更高;血红蛋白[(105.3 ± 15.6)g/L比(147.9 ± 24.8)g/L,P<0.001)]和红细胞压积(31.4 ± 5.3 比 42.5 ± 6.1,P<0.001)更低。结论: 肺癌预后较差,症状不特殊。老年、贫困,诊疗应当重视。

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肺肿瘤,又叫支气管肺癌,是常见的恶性肿瘤之一。肺肿瘤的治疗为包括手术、中药、放疗、化疗及免疫等多学科的综合治疗。

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