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胰腺实性假乳头状肿瘤——临床病理特征及手术结果:一项为期10年的单中心观察性研究

Pancreatic Solid Pseudopapillary Neoplasms-Clinicopathological Characteristics and Surgical Outcomes: A 10-Year Single-Centre Observational Study.

作者信息

Partyka Agnieszka, Bajek Wiktoria, Wietrzycka Paulina, Jabłońska Beata, Mrowiec Sławomir

机构信息

Student Scientific Society, Department of Digestive Tract Surgery, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 14 Medyków Street, 40-752 Katowice, Poland.

Department of Digestive Tract Surgery, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 14 Medyków Street, 40-752 Katowice, Poland.

出版信息

Biomedicines. 2025 Aug 22;13(9):2050. doi: 10.3390/biomedicines13092050.

Abstract

: Pancreatic solid pseudopapillary neoplasms (SPNs) are rare exocrine tumours with predominance in young women. These tumours are of low malignant potential, become considerably large before causing symptoms and are associated with good prognosis. This study aimed to present and analyse clinicopathological features and surgical outcome of SPNs. : A retrospective analysis of 22 patients who underwent pancreatic surgery for SPNs in a single high-volume surgical centre in 2014-2023 was performed. : SPN was the most frequent in females (n = 21, 95.45%) in a mean age of 34 ± 11.09 (18-55) years. Fourteen (63.64%) patients were asymptomatic, and eight (36.36%) presented with symptoms. The most common clinical symptom was abdominal pain (n = 7, 31.82%). The majority of tumours were located in the pancreatic body (n = 8, 36.36%), and most patients underwent distal pancreatectomy (n = 11, 50%). The median tumour size was 3.6 cm (IQR = 4.9; range: 1.3-14). The median duration of hospitalisation was 12.5 days, and the postoperative complication rate was 40.91%. R0 resection was achieved in 18 (81.82%) patients. Postpancreatectomy acute pancreatitis (PPAP) was the most common postoperative complication. No adjuvant therapy in any patient was needed. One-year overall survival (OS) equalled 100% and five-year OS reached 85%. None of the patients developed diabetes or signs of impaired pancreatic secretion in the follow-up period. Histopathology showed features like perineural invasion in 72.73% of cases, pseudocapsule (59.09%), haemorrhage (45.45%), vascular invasion (40.91%), mucosal metaplasia (40.91%), necrosis (31.82%), and calcification in the capsule (31.82%). Ki67 did not exceed 7%. In one case (4.55%), metastasis to a lymph node was found. Clinical suspicion agreed with histopathological results in only 10 (45.45%) cases. : SPN most often occurs in young females. The majority of cases are asymptomatic accidental findings. The final diagnosis of SPN can be based just on analysis of histopathological examination results.

摘要

胰腺实性假乳头状瘤(SPNs)是罕见的外分泌肿瘤,以年轻女性居多。这些肿瘤恶性潜能低,在引起症状前会长得相当大,且预后良好。本研究旨在呈现并分析SPNs的临床病理特征及手术结果。

对2014年至2023年在一个高手术量的单一手术中心接受胰腺手术治疗SPNs的22例患者进行回顾性分析。

SPN在女性中最为常见(n = 21,95.45%),平均年龄为34 ± 11.09(18 - 55)岁。14例(63.64%)患者无症状,8例(36.36%)有症状。最常见的临床症状是腹痛(n = 7,31.82%)。大多数肿瘤位于胰体(n = 8,36.36%),大多数患者接受了胰体尾切除术(n = 11,50%)。肿瘤中位大小为3.6 cm(四分位间距 = 4.9;范围:1.3 - 14)。中位住院时间为12.5天,术后并发症发生率为40.91%。18例(81.82%)患者实现了R0切除。胰十二指肠切除术后急性胰腺炎(PPAP)是最常见的术后并发症。所有患者均无需辅助治疗。1年总生存率(OS)为100%,5年OS达到85%。随访期间无患者发生糖尿病或胰腺分泌功能受损的迹象。组织病理学显示,72.73%的病例有神经周围侵犯、假包膜(59.09%)、出血(45.45%)、血管侵犯(40.91%)、黏膜化生(40.91%)、坏死(31.82%)以及包膜钙化(31.82%)等特征。Ki67不超过7%。1例(4.55%)发现有淋巴结转移。临床怀疑仅在10例(45.45%)病例中与组织病理学结果相符。

SPN最常发生于年轻女性。大多数病例是无症状的偶然发现。SPN的最终诊断仅基于组织病理学检查结果分析。

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