췌장의 선방세포악성종양

Abstract

Acinar cell carcinoma (ACC) is a very rare type of pancreatic cancer that makes up less than 1%of all pancreatic cancers. The prognosis of ACC is very poor and the mean survival interval isonly 18-19 months. The only effective treatment is currently early radical resection.Materials and methods: To determine ACC`s clinical characteristics and the treatment efficacy,we conducted a retrospective chart review to study the clinical characteristics, laboratoryfindings, pathology and treatment responses of 10 ACC patients among 3042 pancreatic cancerpatients who were diagnosed in Severance Hospital and Kangnam Severance Hospital ofYonsei University, College of Medicine from 1988.01.01 to 2008.12.31.Results: The 10 ACC patients were 6 males and 4 females. The mean age of the 10 ACCpatients was 53.2 years. The most of the patients (7/10) complained the pain on the epigastricarea and there was no jaundice in 8 patients (80%). Unfortunately, regional or distantmetastases were founded in 8 patients (80%) at the time of the first diagnosis. The initial meanCA19-9 level was increased to 73.5 U/ml (range: 0.1~350.0 U/ml). Six of 10 patients underwentradical surgery and 4 of 10, including 1 with open and closure, were treated with conservativetreatment. The median survival interval was 22.4 months with operative treatment and 1.5months with conservative treatment. The median overall survival interval was 19.4 months. Themedian disease free survival was 17 months. The liver was the most common recurrent site (3cases).Conclusions: An early radical resection is currently the best and only treatment for ACC, but inrare cases, post-operative adjuvant chemotherapy shows hopeful results and so this requiresmore study.