КЛИНИКО-МОРФОЛОГИЧЕСКАЯ ХАРАКТЕРИСТИКА РАКА ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫ ПО ДАННЫМ АУТОПСИЙ

Abstract

Background. Over the past decades, the incidence of pancreatic cancer (PCa) has been on the rise. It is characterized by a long latent course, non-specificity of clinical symptoms, a tendency to early metastasis, and limited possibilities for biopsy. The survival rate of patients with pancreatic cancer within a year after its diagnosis is no more than 8%. Objective. To study the clinical and morphological features of pancreatic cancer and to assess the state of life-time diagnosis according to autopsy findings. Material and methods. A retrospective analysis of 58 autopsy protocols of patients died due to pancreatic cancer was carried out. The protocols of autopsies as well as micropreparations of the pancreas and other various organs taken during autopsy for histopathological examination were studied. Results. Among those who died due to pancreatic cancer there were 58.6% of men and 41.4% of women. The average age of males was 68.9 years, that of females - 67.0 years. The discrepancy between the pathoanatomical and clinical diagnoses was noted in 7.7% of cases. Chronic pancreatitis as a background disease occurred in 6.9% of cases of pancreatic cancer. A nodular form of cancer growth was detected in 87.9%, a diffuse-infiltrative one - in 12.1% of cases. In 81.0% of cases, the tumor was localized in one of the pancreatic sections, in 19.0% - in several ones. Cancer of the pancreatic head occurred in 72.4% of cases; in 5.2% of cases the tumor was localized only in the tail, in 3.4% - only in the body of the gland. The body and tail of the pancreas were involved in the tumor process in 10.3%, while the head and body in 5.2% of cases. In 3.5% of cases, the tumor completely infiltrated the pancreas. Conclusions. Radical surgical interventions were performed only in 20.7% of cases. They were performed in 28.6% of cases in patients with pancreatic head tumours. In case of tumour location in the distal parts of the pancreas, such interventions were impossible due to the presence of multiple metastases. In 7.7% of cases, the diagnosis of pancreatic cancer was established only at autopsy.