Song He, Dong Ming
Department of Gastrointestinal Surgery of the First Hospital of China Medical University, Shenyang 110001, People's Republic of China.
Cancer Manag Res. 2020 Jul 12;12:5689-5699. doi: 10.2147/CMAR.S256650. eCollection 2020.
Solid pseudopapillary tumors of pancreas (SPTP) is an indolent rare tumor with malignant potential. The prediction of malignancy is an enigma. The aim of this study is to explore the relationship between operative measurements and malignancy prognosis of SPTP patients.
A cohort of consecutive 102 patients were enrolled in this study. Preoperative measurements and clinical outcomes were analyzed.
Eighteen patients (17.6%) were confirmed as malignant. The malignant SPTP of the optimal cut-off value was 47.9 (p=0.012) for prognostic nutritional index (PNI). The value of PNI≤47.9 and incomplete capsule were significantly correlated with malignancy. Univariate analysis showed that the PNI≤47.9 (=0.013) and incomplete capsule (<0.001) were predictors of disease-specific survival (DSS). Multivariate analysis identified the PNI≤47.9 (=0.036) and incomplete capsule (=0.023) as the independent prognostic factors of DSS. The new score of 0,1,2 based on PNI and capsule presence stratified the patients into 3 groups. The patients with low PNI and incomplete capsule achieved the worst prognosis.
The combination test of operative PNI and capsule presence would be a reliable indicator of the aggressive natural history of SPTP.
胰腺实性假乳头状瘤（SPTP）是一种具有恶性潜能的惰性罕见肿瘤。恶性程度的预测是一个谜。本研究的目的是探讨SPTP患者手术测量与恶性预后之间的关系。
本研究纳入了连续的102例患者。分析术前测量结果和临床结局。
18例患者（17.6%）被确诊为恶性。预后营养指数（PNI）的最佳截断值为47.9时，SPTP为恶性（p = 0.012）。PNI≤47.9和包膜不完整与恶性程度显著相关。单因素分析显示，PNI≤47.9（= 0.013）和包膜不完整（< 0.001）是疾病特异性生存（DSS）的预测因素。多因素分析确定PNI≤47.9（= 0.036）和包膜不完整（= 0.023）为DSS的独立预后因素。基于PNI和包膜情况的新评分0、1、2将患者分为3组。PNI低且包膜不完整的患者预后最差。
手术PNI和包膜情况的联合检测将是SPTP侵袭性自然病程的可靠指标。
