胰腺癌r0切除术的进展

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1、授予单位代码10089学号或申请号20153503中国图书分类号R735.9HebeiMedicalUniversity硕士学位论文专业学位胰腺癌R0切除术的进展研究生：刘广超导师：彭利教授专业：外科学二级学院：第四医院2018年3月目录中文摘要············································································································1英文摘要··················

2、··························································································2英文缩写············································································································4综述胰腺癌R0切除术的进展·····································

3、·································5致谢··················································································································27个人简历··································································································

4、········28中文摘要胰腺癌R0切除术的进展摘要胰腺癌是人类较为常见的一种消化系统恶性肿瘤，在发达国家中，胰腺癌在因患癌症而死亡的恶性肿瘤中排名第四位。全球每年新发病例数超过278000例，近年来胰腺癌的发病率有明显增高的趋势，预计在2020年，美国胰腺癌的发病率将超过结直肠癌，成为第二位因患癌症而死亡的病因。90%的胰腺癌患者在诊断后一年内死亡，在美国，胰腺癌的总体5年生存率不到5%，显然，这是一种恶性度极高的恶性肿瘤。90%的胰腺癌为胰腺导管细胞癌，粘液性囊腺癌和腺泡细胞癌较为少见，胰头癌约占

5、胰腺癌70%-80%，手术切除是根治胰腺癌唯一的办法，但是其根治性切除率较低，仅为10%-20%。关于胰腺癌的手术切除范围目前还存在争议，比如R0切除的定义，是否需要行腹膜后神经清扫及周围组织的扩大清扫，清扫的范围等等这一系列问题都需要深入的讨论，在此我们将从R0切除的定义以及如何才能达到R0切除以提高胰腺癌患者术后的生存率等方面来做一综述。1.胰腺癌R0切除的定义及相关临床意义。2.胰周神经清扫与胰腺后缘R0切除的关系。3.胰腺系膜的概念及对其进行清扫的必要性。4.胰头癌行扩大淋巴结清扫不能使患者获益

6、。5.总结与展望。关键词：胰腺癌,R0切除,胰周神经,胰腺系膜,胰腺后切缘1英文摘要TheprogressoftheR0resectionofpancreaticcancerABSTRACTPancreaticcancerisacommonmalignanttumorofthehumandigestivesystem,itranksfourthamongmostcommoncauseofcancer-relateddeathindevelopedcountry.Therearemorethan27800

7、0patientsarediagnosedwithpancreaticcancerintheworldeachyear,meanwhile,theincidenceofpancreaticcancerhasbeenincreasedsignificantlyinrecentyears.Bytheyear2020,itisestimatedthatpancreaticcancerwillsurpasscolorectalcancertobecomethesecondleadingcauseofcancer

8、-relateddeathintheUS.Ninetypercentofthepatientswithpancreaticcancerwilldiedwithinayearafterthedefinitediagnosis.IntheUS,theoverallfive-yearsurvivalrateofpancreaticcancerislessthan5%,itisaterriblemalignanttumorobviously.Nin