Sperti C, Cappellazzo F, Pasquali C, Militello C, Catalini S, Bonadimani B, Pedrazzoli S
Department of Surgery, University of Padua, Italy.
Am Surg. 1993 Nov;59(11):740-5.
From 1970 to 1990 we observed 18 patients with histologically proven pancreatic cystic tumors. The average duration of symptoms prior to diagnosis was 14.1 months. A presumptive diagnosis was made preoperatively in nine patients. CT-guided fine needle cytology performed in three cases correctly showed a benign lesion in one patient and malignancy in two patients. Amylase and tumoral marker levels (CEA, CA19-9) were low in cystic fluid of two patients with cystadenomas who underwent preoperative percutaneous aspiration. Intraoperative biopsy of the cystic wall failed to detect epithelial lining in two cases; one patient had internal drainage for cystadenocarcinoma mistaken for pancreatic pseudocyst. Sixteen patients underwent surgery, two of whom died. Of the seven patients with a malignant condition, resection for cure was performed on three. The preoperative diagnosis of these very rare tumors remains difficult. Fine-needle cytology and cystic fluid examination may be a promising technique, but resection of all suspected lesions, whenever possible, is the procedure of choice for diagnosis and treatment.
1970年至1990年期间，我们观察了18例经组织学证实的胰腺囊性肿瘤患者。诊断前症状的平均持续时间为14.1个月。9例患者在术前做出了初步诊断。3例行CT引导下细针穿刺细胞学检查，其中1例正确显示为良性病变，2例为恶性病变。2例行术前经皮穿刺抽吸的囊腺瘤患者，其囊液中的淀粉酶和肿瘤标志物水平（癌胚抗原、糖类抗原19-9）较低。2例术中对囊壁进行活检未能发现上皮内衬；1例因误诊为胰腺假性囊肿的囊腺癌而进行了内引流术。16例患者接受了手术，其中2例死亡。7例恶性肿瘤患者中，3例行根治性切除术。这些极为罕见肿瘤的术前诊断仍然困难。细针穿刺细胞学检查和囊液检查可能是一种有前景的技术，但只要有可能，切除所有可疑病变是诊断和治疗的首选方法。
