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胰腺实性假乳头状肿瘤:45例临床分析

Solid pseudopapillary neoplasms of the pancreas: clinical analysis of 45 cases.

作者信息

Dai Gaiguo, Huang Ling, Du Yian, Yang Litao, Yu Pengfei

机构信息

Department of Abdominal Surgery, Zhejiang Cancer Hospital Hangzhou 310022, China.

出版信息

Int J Clin Exp Pathol. 2015 Sep 1;8(9):11400-6. eCollection 2015.

Abstract

AIMS

This study investigated the clinicopathological features and surgical management of solid pseudopapillary neoplasms (SPNs) at a single institution in China.

METHODS

We investigated 45 patients who underwent surgery for pathologically confirmed SPNs between 1996 and 2014.

RESULTS

The 45 cases included 44 female and 1 male patients, and the average age was 32.2 years. The tumor was located in the body and/or tail in 33 patients, the head in 9 patients and the neck in 3 patients. The median tumor size was 6.3 cm (range 1.5 to 16). All 45 patients had curative resections including 29 distal pancreatectomies, 9 pancreaticoduodenectomy, 5 central pancreatectomy and 2 enucleation. 2 patients required superior mesenteric vein resection due to local tumor invasion. Eight patients had malignant tumors. Ki-67 was detected positive in 5 patients with malignant potential. After a median follow-up of 51.7 months, one patient with malignant SPN had evidence of tumor recurrence.

CONCLUSION

SPN is an infrequent tumor, typically affect young women with low malignant potential. Surgical resection is warranted even in the presence of local invasion or metastases as patients demonstrate excellent long-term survival. Positive immunoreactivity for Ki-67 may predict the malignant potential and poor outcome of SPNs.

摘要

目的

本研究在中国的一家机构调查实性假乳头状肿瘤(SPN)的临床病理特征及外科治疗方法。

方法

我们调查了1996年至2014年间45例经手术治疗且病理确诊为SPN的患者。

结果

45例患者中包括44例女性和1例男性,平均年龄为32.2岁。肿瘤位于胰体和/或胰尾者33例,位于胰头者9例,位于胰颈者3例。肿瘤中位大小为6.3 cm(范围1.5至16 cm)。45例患者均接受了根治性切除术,包括29例胰体尾切除术、9例胰十二指肠切除术、5例中段胰腺切除术和2例肿瘤剜除术。2例患者因局部肿瘤侵犯需要行肠系膜上静脉切除术。8例为恶性肿瘤。5例具有恶性潜能的患者检测Ki-67呈阳性。中位随访51.7个月后,1例恶性SPN患者出现肿瘤复发迹象。

结论

SPN是一种罕见肿瘤,通常影响年轻女性,恶性潜能低。即使存在局部侵犯或转移,手术切除也是必要的,因为患者有良好的长期生存率。Ki-67免疫反应阳性可能预示SPN的恶性潜能及不良预后。

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