Zhang Ye-Wei, Yan Dong-Liang, Sun Lei, Zheng Su-Wen, Xue Huang-Zhou, Wang Xue-Hao, Wang Tai-Hong
Department of Hepatobiliary and Pancreatic Surgery, Affiliated Jiangsu Cancer Hospital of Nanjing Medical University, Nanjing 210009, China.
Zhonghua Zhong Liu Za Zhi. 2010 Jun;32(6):444-7.
To study the clinicopathological and immunohistochemical features, histogenesis and biological behavior, clinical treatment and prognosis of solid pseudopapillary tumor of the pancreas (SPT).
Routine HE and immunohistochemical (SP) stainings were used in the pathological examination of 18 cases of SPT. Their clinical data were retrospectively analyzed. All the 18 postoperative patients were followed-up for 3 months to 10 years with an average of 29.2 months.
There were 16 females and 2 males, age ranging from 9 to 65 years with mean age of 25.3 years. Abdominal pain and palpable mass were among the major complains. Tumors were encapsulated and mixed with solid and cystic tissues. Histological features were pseudopapillary structure with a fibrovascular core. Immunhistologically, most tumors were positive for alpha-AT, alpha-ACT and Vim, with a high percentage of 94.4%. The eighteen cases were followed-up from 3 to 120 months. Five cases received reoperation after recurrence, and 14 cases were alive. Maximum survival time was 121 months and the minimum survival time was 3 months, with a median survival time of 23.0 months. The 5-year survival rate was 72.2%. A Kaplan-Meier analysis revealed that patient's age, tumor size, pathologic features, metastasis were major prognostic factors for SPT.
SPT is a tumor of low-grade malignancy and may be derived from multipotent stem cells. SPT most frequently affects young female, and has distinct clinicopathologic manifestation with excellent prognosis after surgical treatment.
研究胰腺实性假乳头状瘤(SPT)的临床病理及免疫组化特征、组织发生及生物学行为、临床治疗及预后。
对18例SPT进行病理检查,采用常规HE及免疫组化(SP)染色,回顾性分析其临床资料。18例术后患者均获随访,随访时间3个月至10年,平均29.2个月。
18例中女性16例,男性2例,年龄9~65岁,平均25.3岁。主要症状为腹痛及可触及肿块。肿瘤有包膜,由实性和囊性组织混合而成。组织学特征为假乳头状结构伴纤维血管轴心。免疫组化显示,多数肿瘤α-AT、α-ACT及Vim阳性,阳性率高达94.4%。18例随访3~120个月。5例复发后再次手术,14例存活。最长生存时间121个月,最短生存时间3个月,中位生存时间23.0个月。5年生存率为72.2%。Kaplan-Meier分析显示,患者年龄、肿瘤大小、病理特征、有无转移是SPT的主要预后因素。
SPT是一种低度恶性肿瘤,可能来源于多能干细胞。SPT多见于年轻女性,具有独特的临床病理表现,手术治疗后预后良好。