胰腺黏液性肿瘤22例临床诊治分析

The diagnosis and surgical treatment of pancreatic mucinous tumor

目的探讨胰腺黏液性肿瘤的诊断和治疗。方法对1999年1月至2007年6月我院腹部外科收治的经病理证实的22例胰腺黏液性肿瘤的临床资料进行回顾性分析。结果胰腺导管内乳头状黏液性肿瘤3例,黏液非囊性癌11例,黏液性囊性肿瘤8例。临床表现无特异性,影像学检查难以确诊。22例均行手术治疗,术后2例失访。黏液性囊性肿瘤术后1例因复发转移死亡;导管内乳头状黏液性肿瘤1例出现复发转移死亡;黏液非囊性癌失访2例,其余均于5～22个月内死亡,平均生存期10个月。结论胰腺黏液性肿瘤是一种恶性或潜在恶性病变。胰腺导管内乳头状黏液性肿瘤和胰腺黏液性囊性肿瘤根治性切除术后疗效满意,胰腺黏液非囊性癌预后差,生物学特点有待于进一步研究。

Objective To explore the diagnosis and treatment of pancreatic mucinous tumor. Methods Twenty - two cases of pancreatic mutinous tumor treated in our hospital were studied retrospectively. The clinical and pathologic data were reviewed. Results Of 22 eases, 3 were diagnosed as having intraductal papillary mucinous tumor, 11 having mutinous noneystic adenocarcinoina, 8 having eystoadenoma or eystoadenocareinoma. Most of the patients had no specific symptom and preoperative radiography could not make definite diagnosis. All 22 eases underwent operation. One case of intraduetal papillary mueinous tumor and 1 case of cystoadenocarcinoma died of recurrence and metastasis after operation. All eases of mueinous noneystie adenoearcinoma died within 5 - 22 months except 2 cases lost of follow - up, and average survival time was 10 months. Conclusion Pancreatic mucinous tumors are malignant or have potential to malignancy. Radical resection can lead to good prognosis in intraductal papillary maeinous tumor and cystoadenoma or cystoadenocarcinoma. Prognosis of mueinous noneysfie adenocarcinoma is poor, and its biological features deserve further study.