Xu Ming-Yue, Shi Xian-Jie, He Lei, Lu Fang, Chen Ming-Yi, Wang Hong-Guang, Lu Shi-Chun
Department of Hepatobiliary Surgery, General Hospital of PLA, Beijing 100853, China. E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2016 Jun;36(6):780-4.
To compare the clinicopathological characteristics and prognosis of patients with small (≤5 cm) solid pseudopapillary neoplasm of the pancreas (SPN) and those with large (>5 cm) SPNs.
We retrospectively analyzed the clinical characteristics, laboratory findings, radiological features, treatment and prognosis of 148 patients with histologically confirmed SPN between August, 2006 and December, 2014 and compared the data between patients with small SPNs (≤5 cm) and those with large SPNs (>5 cm).
In the large SPN group, the female-to-male ratio was significantly higher than that in small SPN group (61/8 vs 56/23, P=0.009) and the patients were significantly younger in large SPN group (28.3±12.3 vs 33.0±11.4 years, P=0.016). Small SPNs (≤5 cm) typically presented as inhomogeneous solid or cystic tumors, while large SPNs (>5 cm) often appeared as homogeneous solid and cystic tumors, but they did not show any significant difference in aggressive behaviors (P=0.288). The 5-year disease-free survival of patients with small SPNs was 100%, and the 1-, 3-, and 5-year disease-free survival of patients with large SPNs was 98.6%, 94.9%, and 89.3%, respectively (P=0.030), showing no significant differences in the overall survival between the two groups.
Small SPNs and large SPNs have different clinical characteristics. Even with complete resection, tumors larger than 5 cm are more likely to have tumor recurrence and metastasis, and close follow-up is recommended for these patients.
比较胰腺实性假乳头状瘤(SPN)直径≤5 cm的患者与直径>5 cm的患者的临床病理特征及预后。
回顾性分析2006年8月至2014年12月期间148例经组织学确诊的SPN患者的临床特征、实验室检查结果、影像学特征、治疗及预后情况,并比较直径≤5 cm的小SPN患者与直径>5 cm的大SPN患者的数据。
大SPN组的女性与男性比例显著高于小SPN组(61/8 vs 56/23,P = 0.009),且大SPN组患者明显更年轻(28.3±12.3岁 vs 33.0±11.4岁,P = 0.016)。小SPN(≤5 cm)通常表现为不均匀的实性或囊性肿瘤,而大SPN(>5 cm)常表现为均匀的实性和囊性肿瘤,但它们在侵袭性行为方面无显著差异(P = 0.288)。小SPN患者的5年无病生存率为100%,大SPN患者的1年、3年和5年无病生存率分别为98.6%、94.9%和89.3%(P = 0.030),两组的总生存率无显著差异。
小SPN和大SPN具有不同的临床特征。即使完全切除,直径大于5 cm的肿瘤更易发生肿瘤复发和转移,建议对这些患者进行密切随访。