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胰腺实性假乳头状瘤:单中心经验及文献复习。

Solid Pseudopapillary Neoplasms of the Pancreas: a Single-Center Experience and Review of the Literature.

机构信息

Department of HPB Surgery and Liver Transplant, Royal Free Hospital NHS Foundation Trust, London, UK.

Department of Cellular Pathology, Royal Free London NHS Foundation Trust, London, UK.

出版信息

J Gastrointest Cancer. 2022 Jun;53(2):460-465. doi: 10.1007/s12029-021-00638-6. Epub 2021 Apr 20.

DOI:10.1007/s12029-021-00638-6
PMID:33877570
Abstract

PURPOSE

Pancreatic solid pseudopapillary neoplasms (SPNs) are rare borderline tumours mainly affecting young female patients. The number of patients diagnosed with SPNs has increased significantly in the last decades owing to the increased use of cross-sectional imaging investigating different abdominal symptoms, whilst a significant proportion are incidentally discovered during the process of evaluating other pathologies. We herein present our institutional experience of patients with SPN who underwent curative resection focusing on clinical, pathological features, and the long-term outcomes.

METHODS

All patients undergoing pancreatectomy in our institution for SPN from January 2010 until December 2018 were included. Clinical, perioperative, histological, and long-term outcomes were collected and analysed.

RESULTS

During the inclusion period, a total of 19 patients had a pathological diagnosis of SPNs after surgical resection. Sixteen of them were female (84%), while the median patient age was 30 (range 16-66) years. Nine patients (47%) underwent distal pancreatectomy and splenectomy, 2 (11%) underwent spleen preserving distal pancreatectomy, 6 (32%) underwent pancreatoduodenectomy, one (5%) underwent total pancreatectomy, and one (5%) central pancreatectomy. Seventeen patients underwent R0 resection. During a median follow-up of 23 months, no tumour recurrence or death was recorded.

CONCLUSION

In our experience, SPNs are rare tumours with low malignant potentials. Surgical resection remains the gold standard treatment and is associated with good prognosis.

摘要

目的

胰腺实性假乳头状瘤(SPN)是一种罕见的交界性肿瘤,主要影响年轻女性患者。由于横断面成像技术在研究不同腹部症状中的广泛应用,过去几十年诊断为 SPN 的患者数量显著增加,而相当一部分患者是在评估其他病变过程中偶然发现的。本文主要介绍了我们机构中接受根治性切除术的 SPN 患者的临床病理特征和长期预后。

方法

纳入了 2010 年 1 月至 2018 年 12 月期间在我院接受胰腺切除术治疗 SPN 的所有患者。收集并分析了临床、围手术期、组织病理学和长期结果。

结果

在纳入期间,共有 19 例患者在手术切除后被病理诊断为 SPN。其中 16 例为女性(84%),中位年龄为 30 岁(范围 16-66 岁)。9 例(47%)患者接受了远端胰腺脾脏切除术,2 例(11%)患者接受了保留脾脏的远端胰腺脾脏切除术,6 例(32%)患者接受了胰十二指肠切除术,1 例(5%)患者接受了全胰腺切除术,1 例(5%)患者接受了中央胰腺切除术。17 例患者接受了 R0 切除术。中位随访 23 个月期间,未记录到肿瘤复发或死亡。

结论

在我们的经验中,SPN 是一种罕见的低度恶性肿瘤。手术切除仍然是金标准治疗方法,且预后良好。

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Pancreas. 2019 Nov/Dec;48(10):1334-1342. doi: 10.1097/MPA.0000000000001426.
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Investigation of Fluorodeoxyglucose Positron Emission Tomography for the Diagnosis of Solid Pseudopapillary Neoplasm of the Pancreas: A Study Associated With a National Survey of Solid Pseudopapillary Neoplasms.氟脱氧葡萄糖正电子发射断层扫描用于胰腺实性假乳头状肿瘤诊断的研究:一项与全国实性假乳头状肿瘤调查相关的研究
Pancreas. 2019 Nov/Dec;48(10):1312-1320. doi: 10.1097/MPA.0000000000001424.
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The 2019 WHO classification of tumours of the digestive system.
2019年世界卫生组织消化系统肿瘤分类。
Histopathology. 2020 Jan;76(2):182-188. doi: 10.1111/his.13975. Epub 2019 Nov 13.
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Analysis of 50 cases of solid pseudopapillary tumor of pancreas: Aggressive surgical resection provides excellent outcomes.胰腺实性假乳头状瘤 50 例分析:积极的手术切除可获得良好的结果。
Eur J Surg Oncol. 2019 Feb;45(2):187-191. doi: 10.1016/j.ejso.2018.08.027. Epub 2018 Sep 8.
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Prediction of malignancy and adverse outcome of solid pseudopapillary tumor of the pancreas.胰腺实性假乳头状瘤恶性及不良预后的预测
World J Gastrointest Oncol. 2018 Jul 15;10(7):184-193. doi: 10.4251/wjgo.v10.i7.184.
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Tumor size classification of the 8 edition of TNM staging system is superior to that of the 7 edition in predicting the survival outcome of pancreatic cancer patients after radical resection and adjuvant chemotherapy.第八版 TNM 分期系统的肿瘤大小分类在预测胰腺癌患者根治性切除术后辅助化疗的生存结局方面优于第七版。
Sci Rep. 2018 Jul 10;8(1):10383. doi: 10.1038/s41598-018-28193-4.
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Solid Pseudopapillary Neoplasms of the Pancreas: A Surgical and Genetic Enigma.胰腺实性假乳头状肿瘤:一个外科和遗传学谜团。
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Solid pseudopapillary neoplasm of the pancreas: Management and long-term outcome.胰腺实性假乳头状肿瘤:治疗与长期预后
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