Gastroenterology Surgical Center, Mansoura University, Egypt.
Saudi J Gastroenterol. 2013 Jan-Feb;19(1):45-53. doi: 10.4103/1319-3767.105927.
BACKGROUND/AIM: Pancreatic cystic neoplasms are being increasingly identified with the widespread use of advanced imaging techniques. In the absence of a good radiologic or pathologic test to preoperatively determine the dianosis, clinical characteristics might be helpful. The objectives of this analysis were to define the incidence and predictors of malignancy in pancreatic cysts.
Patients with true pancreatic cysts who were treated at our institution were included. Patients with documented pseudocysts were excluded. Demographic data, clinical manifestations, radiological, surgical, and pathological records of those patients were reviewed.
Eighty-one patients had true pancreatic cyst. The mean age was 47 ± 15.5 years. There were 28.4% serous cystadenoma, 21% mucinous cystadenoma, 6.2% intraductal papillary tumors, 8.6% solid pseudopapillary tumors, 1.2% neuroendocrinal tumor, 3.7% ductal adenocarcinoma, and 30.9% mucinous cystadenocarcinoma. Malignancy was significantly associated with men (P = 0.04), older age (0.0001), cysts larger than 3 cm in diameter (P = 0.001), presence of solid component (P = 0.0001), and cyst wall thickening (P = 0.0001). The majority of patients with malignancy were symptomatic (26/28, 92.9%). The symptoms that correlated with malignancy included abdominal pain (P = 0.04) and weight loss (P = 0.0001). Surgical procedures were based on the location and extension of the lesion.
The most common pancreatic cysts were serous and mucinous cysts. These tumors were more common in females. Old age, male gender, large tumor, presence of solid component, wall thickness, and presence of symptoms may predict malignancy in the cyst.
背景/目的：随着先进影像学技术的广泛应用，胰腺囊性肿瘤的检出率逐渐增高。在缺乏术前确定诊断的良好影像学或病理学检查的情况下，临床特征可能具有一定帮助。本分析的目的是确定胰腺囊肿恶性肿瘤的发生率和预测因素。
本研究纳入在我院接受治疗的真性胰腺囊肿患者。排除有明确记录的假性囊肿患者。回顾性分析这些患者的人口统计学数据、临床表现、影像学、手术和病理学记录。
81 例患者存在真性胰腺囊肿，平均年龄为 47 ± 15.5 岁。其中浆液性囊腺瘤占 28.4%，黏液性囊腺瘤占 21%，导管内乳头状肿瘤占 6.2%，实性假乳头状瘤占 8.6%，神经内分泌肿瘤占 1.2%，导管腺癌占 3.7%，黏液性囊腺癌占 30.9%。恶性肿瘤与男性（P = 0.04）、年龄较大（0.0001）、直径大于 3 cm 的囊肿（P = 0.001）、存在实性成分（P = 0.0001）和囊壁增厚（P = 0.0001）显著相关。大多数恶性肿瘤患者有症状（28/28，92.9%）。与恶性肿瘤相关的症状包括腹痛（P = 0.04）和体重减轻（P = 0.0001）。手术方案基于病变的位置和范围。
最常见的胰腺囊肿是浆液性和黏液性囊肿。这些肿瘤在女性中更为常见。年龄较大、男性、肿瘤较大、存在实性成分、囊壁增厚和有症状可能预示着囊肿存在恶性肿瘤。
