胰腺实性假乳头肿瘤的主要临床特征及诊断要点

The solid-pseudopapiHary tumor of pancreas：the clinical characteristics and diagnosis

目的总结胰腺实性假乳头肿瘤（SPT）的临床特点和诊断要点。方法回顾性分析经术后病理确诊为SPT40例患者的临床诊治资料。患者平均年龄（32．9±13．6）岁，平均病程（8．6±0．1）个月，男：女为1：9。临床症状多为腹部胀痛或隐痛不适（60．0％），无一例皮肤、巩膜黄染。结果所有患者术后未行化、放疗。4例术后发生水肿性胰腺炎，经积极治疗痊愈。36例获得随访，随访时间为4～132个月，均未见肿瘤复发。SPT大体剖面呈囊实性相间结构，镜下特点为假乳头状结构和区域性坏死，无腺泡结构。结论SPT有其相对独特的临床特征，其诊断要点有助于临床医生及时做出诊断，减少误诊、误治。

Objective To study the clinical characteristics and diagnosis of the solid-pseudopapillary tumor of pancreas （SPT）. Methods The clinical data of 40 SPT from January 1996 to January 2008 were retrospectively analyzed. The average age was （32.9 ± 13.6 ）years. The average clinical course was （8.6 ± 0.1 ） months. Clinical symptoms usually included distensible pains and secret anguish in abdomen （ 60.0% ）. No jaundice appeared in any case. Results The surgical resection was favorable for the treatment of SPT,which had excellent prognosis. No tumor recurrence were found in those following-up patients. Grossly, the cut surface showed areas of solid and papillary tissue, cystic degeneration, hemorrhage, and necrosis. Pathological features included a combination of solid and cystic components with pseudopapillae formation and degenerative regions without glands. Conclusions SPT has its uniquely clinical and pathological characteristics. Its main diagnosed points are. helpful for clinical doctors to make timely diagnosis and reduce the rate of misdiagnosis and mistreatment.