Department of Endoscopy, Fudan University Shanghai Cancer Center, No. 270 Dong'An Road, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Pancreatic Cancer Institute, Shanghai, China.
Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, No. 270 Dong'An Road, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Pancreatic Cancer Institute, Shanghai, China.
Clin Res Hepatol Gastroenterol. 2020 Nov;44(6):947-953. doi: 10.1016/j.clinre.2020.02.002. Epub 2020 Mar 3.
To differentiate solid-pseudopapillary tumors (SPTs) of the pancreas from pancreatic neuroendocrine tumors (pNETs) by endoscopic ultrasound.
We retrospectively reviewed all patients with SPTs and pNETs who underwent endoscopic ultrasound (EUS) from May 2012 to August 2018 at the Fudan University Shanghai Cancer Center. We included patients confirmed pathologically with a surgical biopsy or with endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). The demographic data of the patients, characteristics of the lesions and overall survival data of patients with these two diseases were further compared.
A total of 147 pNET patients and 21 SPT patients were included in our study. The mean ages of the patients in the SPT and pNET groups were 35.95years and 54.30years, respectively. There were more females in the SPT group than in the pNET group (71.43% vs. 40.82%). The patients in the pNET group had significantly more lymphatic metastases and visceral organ metastases than the patients in the SPT group. A larger proportion of pNET lesions than SPT lesions had homogeneous echo patterns and were hypervascular. Cystic components and calcification components were more often observed in the SPT lesions than in the pNET lesions. In the multivariate logistic regression analysis, the hypervascularization (OR: 6.528, 95% CI: 1.562-27.285, P=0.010) and cystic component (OR: 0.106, 95% CI: 0.019-0.597, P=0.011) variables resulted in the best discrimination of patients with SPTs from patients with pNETs. Survival among patients with SPTs was higher than that among patients with pNETs at all points in the follow-up period.
SPTs tended to occur in younger people and were more common in women. Pancreatic neuroendocrine tumors tended to form metastases more often than SPTs. The blood supply and cystic components of the lesions may have novel potential diagnostic utility for differentiating SPTs from pNETs.
通过内镜超声对胰腺实性假乳头状瘤（SPT）与胰腺神经内分泌肿瘤（pNET）进行鉴别。
回顾性分析 2012 年 5 月至 2018 年 8 月在复旦大学附属肿瘤医院接受内镜超声（EUS）检查的 SPT 和 pNET 患者。纳入经手术活检或内镜超声引导下细针抽吸（EUS-FNA）病理证实的患者。进一步比较两组患者的一般资料、病变特征和总生存数据。
共纳入 147 例 pNET 患者和 21 例 SPT 患者。SPT 组和 pNET 组患者的平均年龄分别为 35.95 岁和 54.30 岁。SPT 组女性患者明显多于 pNET 组（71.43% vs. 40.82%）。pNET 组患者的淋巴结转移和内脏器官转移明显多于 SPT 组患者。pNET 病变的回声均匀性和高血管化比例显著高于 SPT 病变。SPT 病变较 pNET 病变更常出现囊性成分和钙化成分。多因素 logistic 回归分析显示，高血管化（OR：6.528，95%CI：1.562-27.285，P=0.010）和囊性成分（OR：0.106，95%CI：0.019-0.597，P=0.011）是鉴别 SPT 和 pNET 的最佳变量。SPT 组患者的生存情况在随访期间的所有时间点均高于 pNET 组。
SPT 好发于年轻人，女性多见。pNET 较 SPT 更易发生转移。病变的血供和囊性成分可能为鉴别 SPT 和 pNET 提供新的潜在诊断价值。
