Liu Yuanhao, Peng Junya, Zhao Yupei, Wang Wenze
Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, PR China.
Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, PR China.
J Pathol Clin Res. 2025 May;11(3):e70029. doi: 10.1002/2056-4538.70029.
Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare, low-grade malignant tumor, representing 0.9-2.7% of all exocrine pancreatic tumors. SPN patients generally have a favorable prognosis with a 5-year survival rate exceeding 95% following complete surgical resection. Accurate diagnosis is crucial to avoid unnecessary treatments. Currently, SPN diagnosis relies on imaging techniques such as CT and MRI, along with immunohistochemical analysis of biopsy and resection samples. The main challenge in diagnosis is the potential inability to accurately identify recurrent or metastatic SPN, as well as 'malignant' SPN, due to the lack of specific biomarkers. Advances in high-throughput omics technologies, including genomics, transcriptomics, proteomics and metabolomics, have opened new avenues for identifying novel biomarkers for SPN. Additional, liquid biopsy techniques have enabled more comprehensive analysis of biosamples such as pancreatic cyst fluid, offering promising prospects for preoperative diagnosis. This review highlights recent research on SPN diagnosis, focusing on immunohistochemical markers, tissue sampling methods and the potential of omics approaches. It also discusses the challenges and opportunities in improving diagnostic accuracy, particularly for high-grade and metastatic SPNs.
胰腺实性假乳头状肿瘤（SPN）是一种罕见的低级别恶性肿瘤，占所有胰腺外分泌肿瘤的0.9%-2.7%。SPN患者总体预后良好，完整手术切除后5年生存率超过95%。准确诊断对于避免不必要的治疗至关重要。目前，SPN的诊断依赖于CT和MRI等成像技术，以及对活检和切除样本的免疫组化分析。诊断的主要挑战在于，由于缺乏特异性生物标志物，可能无法准确识别复发性或转移性SPN以及“恶性”SPN。包括基因组学、转录组学、蛋白质组学和代谢组学在内的高通量组学技术的进展，为识别SPN的新型生物标志物开辟了新途径。此外，液体活检技术能够对胰腺囊肿液等生物样本进行更全面的分析，为术前诊断提供了广阔前景。本综述重点介绍了近期关于SPN诊断的研究，聚焦于免疫组化标志物、组织采样方法和组学方法的潜力。它还讨论了提高诊断准确性，特别是对高级别和转移性SPN的诊断准确性方面的挑战和机遇。
