目的：探讨影响胰腺癌早期诊断、可切除性判断及预后的因素。 方法：回顾2011 年3 月―2014 年3 月收治的185 例胰腺癌患者临床资料，通过与手术结果比较，对 各影像学检查判断肿瘤可切除性效率进行评价；分析预后影响因素。 结果：全组男103 例，女82 例；平均年龄（58.87±10.59）岁；主要临床症状为腹痛、腹胀和黄疸； 行手术治疗74 例，未行手术111 例。术前影像学检查以B 超和CT 为主，B 超、CT、MRI、PET/CT 判断肿瘤可切除性的ROC 曲线下面积（95% CI）分别为0.524（0.343~0.705）、0.727（0.604~0.850）、 0.571（0.000~1.000）、0.500（0.010~0.990）。共获得随访资料90 例，中位生存期7.05 个月，患者1、 2、3 年生存率分别为29%、16%、8%；单因素分析提示有无肝转移、肿瘤分期和治疗方式是影响胰腺 癌预后的因素（均P<0.05）。 结论：胰腺癌预后极差，可切除性判断可依赖于CT 为主的影像检查，有无肝转移、肿瘤分期和治疗 方式是重要的预后影响因素。早期诊断、治疗是延长胰腺癌患者生存时间、改善患者预后的关键。
Diagnosis and treatment of pancreatic cancer: a retrospective analysis of 185 cases
Objective: To investigate influential factors for early diagnosis, estimation of resectability and prognosis of pancreatic cancer. Methods: The clinical data of 185 patients with pancreatic cancer admitted from March 2011 to March 2014 were reviewed. The efficiencies of various imaging examinations in estimation of resectability were evaluated by comparing the surgical results, and the prognostic factors were also analyzed. Results: Of the entire group of patients, 103 cases were male and 82 were female with an average age of (58.87±10.59) years; the main clinical symptoms were abdominal pain, abdominal distention and jaundice; 74 cases underwent surgical treatment and 111 cases did not. B-ultrasound and CT were the main preoperative imaging methods of examination, and the area under ROC curve (95% CI) of B-ultrasound, CT, MRI and PET/CT for estimation of resectability was 0.524 (0.343–0.705), 0.727 (0.604–0.850), 0.571 (0.000–1.000) and 0.500 (0.010–0.990), respectively. Follow-up data were obtained in 90 patients, and the 1-, 2- and 3-year survival rate was 29%, 16% and 8%, respectively. Univariate analysis suggested that liver metastasis, TNM stage and treatment approach were influential factors for prognosis (all P<0.05). Conclusion: The prognosis of pancreatic cancer is extremely poor, and its estimation of resectability can depend on the CT-based imaging examinations, and liver metastasis, TNM stage and the therapeutic approach are important prognostic factors. Early diagnosis and treatment are important for improving the survival time and prognosis of the patients.