Wei Guangmin, Luo Qiong, Fang Jiankai, Li Xiaolou, Shi Yanhong, Li Yuqiong, Sun Liqi
Department of Oncology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China.
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Front Oncol. 2022 Feb 18;12:844182. doi: 10.3389/fonc.2022.844182. eCollection 2022.
Solid pseudopapillary neoplasms of the pancreas (SPNs) in male patients are more frequently reported. The aim of the study was to evaluate the sex features of SPN and the risk factors that predict tumor recurrence.
From 2013 to 2019, patients who were pathologically confirmed to have SPNs were retrospectively reviewed. The baseline study parameters were compared between males and females. A logistic regression model was established to identify the independent risk factors for tumor recurrence.
In total, 221 patients were included in this study. Of them, 53 patients (24.0%) were males. Male patients were older than female patients (39.1 vs 31.6 years, P=0.001), and the tumor size in male patients was smaller than that in female patients (50.38 vs 39.65 mm, P=0.038). The preoperative imaging diagnostic accuracy was significantly higher in females than in males (70.5% vs 54%, P=0.02). SPNs in male patients tended to be misdiagnosed with other malignant tumors (37.7% vs 10.7%, P<0.0001), with a more solid component observed in images (66.8% vs 24.7%, P<0.0001). For immunohistochemical staining, the expression of beta catenin was significantly lower in male patients (P=0.002), and the expression of vimentin was the opposite (P=0.01). The overall survival rate and disease-free survival were not different. Based on multivariate analysis, older age [hazard ratio (HR)= 1.094, 95% confidence interval (CI): 1.005-1.190] and KI 67 index grade III (HR=12.029, 95% CI: 2.399-60.311) were independent risk factors for tumor recurrence.
The clinical and imaging features of SPN in males were not in full accord with those in females; however, the differences did not influence prognosis.
胰腺实性假乳头状肿瘤（SPN）在男性患者中的报道更为常见。本研究的目的是评估SPN的性别特征以及预测肿瘤复发的危险因素。
回顾性分析2013年至2019年经病理确诊为SPN的患者。比较男性和女性患者的基线研究参数。建立逻辑回归模型以确定肿瘤复发的独立危险因素。
本研究共纳入221例患者。其中，53例（24.0%）为男性。男性患者年龄大于女性患者（39.1岁对31.6岁，P = 0.001），男性患者的肿瘤大小小于女性患者（50.38mm对39.65mm，P = 0.038）。女性患者术前影像诊断准确率显著高于男性（70.5%对54%，P = 0.02）。男性患者的SPN更容易被误诊为其他恶性肿瘤（37.7%对10.7%，P < 0.0001），影像中观察到的实性成分更多（66.8%对24.7%，P < 0.0001）。免疫组化染色显示，男性患者中β-连环蛋白的表达显著降低（P = 0.002），波形蛋白的表达则相反（P = 0.01）。总生存率和无病生存率无差异。多因素分析显示，年龄较大[风险比（HR）= 1.094，95%置信区间（CI）：1.005 - 1.190]和KI 67指数III级（HR = 12.029，95% CI：2.399 - 60.311）是肿瘤复发的独立危险因素。
男性SPN的临床和影像特征与女性并不完全一致；然而，这些差异并不影响预后。
