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胰腺实性假乳头状肿瘤的诊断与外科治疗

[Diagnosis and surgical treatment of solid-pseudopapillary tumor of the pancreas].

作者信息

Kang Wei-ming, Liao Quan, Zhao Yu-pei, Hu Ya

机构信息

Department of Basic Surgery, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2004 Jun;26(3):310-2.

Abstract

OBJECTIVE

To study the diagnosis and treatment of solid-pseudopapillary tumor of the pancreas (SPTP).

METHODS

The clinical course, surgical treatment, and pathological findings of 13 patients with SPTP were analyzed.

RESULTS

SPTP has no specific clinical symptoms. The patients mostly have abdominal pain and space occupying symptoms. Laboratory investigations of some patients showed decreased pancreatic exocrine function and elevated CA242 of tumor markers. Ultrasonography and CT revealed large solid cystic tumor of pancreas. Digital subtraction angiography (DSA) showed lacked-blood-supply space occupying lesion. All tumors were resected successfully. The histological findings showed a large encapsulated tumor and the section of tumor surrounded by hemorrhagic and necrotic areas. The solid areas are composed of small and medium size tumor cells, which had no obvious atypia. Psudopapillary structures were found in the cystic degeneration areas. Immunohistochemically, most of the tumors were positive for alpha-antitrypsin (alpha-AT) and vimentin and negative for chromogrannin. No patients recurrence during the follow-up.

CONCLUSIONS

Most of SPTP can be removed successfully after diagnosis. The tumor and local infiltration tissue should be removed completely, and the long-term prognosis of SPTP is good.

摘要

目的

探讨胰腺实性假乳头状瘤(SPTP)的诊断与治疗。

方法

分析13例SPTP患者的临床病程、手术治疗及病理结果。

结果

SPTP无特异性临床症状。患者多有腹痛及占位症状。部分患者实验室检查显示胰腺外分泌功能降低,肿瘤标志物CA242升高。超声及CT显示胰腺巨大实性囊性肿瘤。数字减影血管造影(DSA)显示乏血供占位性病变。所有肿瘤均成功切除。组织学检查显示肿瘤有完整包膜,肿瘤切面周围有出血坏死区。实性区域由中小 sized肿瘤细胞组成,无明显异型性。在囊性变区域发现假乳头结构。免疫组化显示,多数肿瘤α1抗胰蛋白酶(α1-AT)和波形蛋白阳性,嗜铬粒蛋白阴性。随访期间无患者复发。

结论

多数SPTP诊断后可成功切除。应完整切除肿瘤及局部浸润组织,SPTP的长期预后良好。

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