McCluney Simon, Wijesuriya Nilukshi, Sheshappanavar Vinayata, Chin-Aleong Joanne, Feakins Roger, Hutchins Robert, Abraham Ajit, Bhattacharya Satyajit, Valente Roberto, Kocher Hemant
Barts and the London HPB Centre, Department of Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK.
Barts Cancer Institute, Queen Mary University of London, London, UK.
ANZ J Surg. 2018 Sep;88(9):891-895. doi: 10.1111/ans.14362. Epub 2018 Jan 8.
We report on our experience of the surgical management and outcomes of 11 patients with solid pseudopapillary tumour of the pancreas (SPT). We sought to correlate the immunohistochemical staining of these tumours with that previously reported in the literature.
A retrospective analysis of the clinical presentation, radiological findings, surgical treatment, histopathological characteristics and outcomes for patients surgically managed with SPT at The Royal London Hospital. A literature search was performed to analyse the immunohistochemical stains commonly used to diagnose SPT.
Between August 2006 and April 2016, 10 females and one male patient underwent surgery for SPT. The localization of the tumour was in the pancreatic head in two patients, one in the neck, three in the body and five in the tail. All 11 patients had localised disease. Six patients suffered post-surgical complications. Histopathology shows immunoreactivity for: β-catenin, vimentin, CD-10, CD-56, α1-antitrypsin and negative staining for synaptophysin and chromogranin. At a median of 24 months of follow-up, the disease-free survival rate was 100% and no recurrence was noted. A literature review generated 38 suitable articles with 116 individual cases of SPT, with high expression of vimentin and neuron specific enolase throughout, and low rates of chromogranin and synatophysin positivity.
SPT is rare and affects mostly young women. An accurate diagnosis is important as the relative indolent behaviour can be managed with surgical resection even when large in size, bringing excellent long-term outcomes.
我们报告了11例胰腺实性假乳头状瘤（SPT）患者的手术治疗经验及结果。我们试图将这些肿瘤的免疫组化染色结果与先前文献报道的结果进行关联。
对在皇家伦敦医院接受SPT手术治疗的患者的临床表现、影像学检查结果、手术治疗、组织病理学特征及结果进行回顾性分析。进行文献检索以分析常用于诊断SPT的免疫组化染色。
2006年8月至2016年4月期间，10例女性和1例男性患者接受了SPT手术。肿瘤位于胰头2例，颈部1例，体部3例，尾部5例。所有11例患者均为局限性疾病。6例患者出现术后并发症。组织病理学显示：β-连环蛋白、波形蛋白、CD-10、CD-56、α1-抗胰蛋白酶呈免疫反应性，突触素和嗜铬粒蛋白呈阴性染色。中位随访24个月时，无病生存率为100%，未观察到复发。文献综述产生了38篇合适的文章，其中有116例SPT个体病例，波形蛋白和神经元特异性烯醇化酶始终高表达，嗜铬粒蛋白和突触素阳性率低。
SPT罕见，主要影响年轻女性。准确的诊断很重要，因为即使肿瘤体积较大，其相对惰性的行为也可通过手术切除进行处理，从而带来优异的长期结果。
