转移性胰腺实性假乳头状瘤的临床病理与预后分析

Metastatic solid pseudopapillary tumor of the pancreas

目的总结分析转移性胰腺实性假乳头状瘤的特殊病理学表现、治疗及临床预后特点。方法回顾性分析1985年6月至2005年12月间共25例转移性胰腺实性假乳头状瘤患者的临床病例资料，采用Kaplan—Meier生存分析确定影响其预后的危险因素。结果23例病例获得随访至2007年12月，随访率为92％，中位随访时间78个月，术后5年生存率为82％。生存分析显示：患者年龄、肿瘤大小、特殊病理表现、转移灶数目和大血管浸润是影响患者生存时间的危险因素。结论胰腺实性假乳头状瘤为低度恶性肿瘤，预后较好。但转移性胰腺实性假乳头状瘤患者预后相对较差，患者年龄（≥40岁）、肿瘤直径（≥6cm）、特殊病理表现（包括弥漫性生长和坏死）、多发转移灶和大血管浸润是其预后的危险因素。

Objective To analyze pathologic features, therapeutic strategies and prognosis of patients with metastatic solid pseudopapillary tumor of the pancreas （m-SPTP）. Methods Twenty five patients with m-SPTP undergoing radical resection between June 1985 and Dec 2005 were retrospectively analyzed. Kaplan-Meier analysis was used to screen out risk factors of the prognosis of m-SPTP patients. Results Twenty-three postoperative patients were followed up until Dec 2007. The follow-up rate was 92% and the median follow up time was 78 months. The 5-year overall survival rate was 82%. Kaplan-Meier analysis showed that five variables including age, tumor size, pathologic features, number of metastatic lesions and lymphatic metastasis were related to overall survival. Conclusions Solid pseudopapillary tumor of the pancreas is low-grade malignant potential with a favorable prognosis, but not for the m-SPTP. Patients of ≥40 years old, tumor size （ ≥ 6 cm） , pathologic features （ including presence of areas with diffuse growth pattern and tumor necrosis） , multiple metastatic lesions and lymphatic metastasis have poor prognosis.