胰腺实性假乳头状瘤的国内文献荟萃分析

Meta analysis of solid pscudopapillary tumors of the pancreas

目的 总结分析国内胰腺实性假乳头状瘤（SPT）的临床诊治现状及其预后。方法检索1992年1月至2009年4月中国期刊全文数据库文献，获得临床资料完备的42篇文献共439例SPT，对其临床资料进行分析总结。结果439例SPT中男性38例（8．7％），女性401例（91．3％），男：女=1：10．6，平均年龄28岁（8～76岁）。377例有临床表现描述，主要为腹痛（35。3％）、腹部包块（31．3％）、腹胀不适（7．7％），101例（26．8％）无任何症状，为体检时偶然发现。术前诊断有记载者246例，误诊161例，误诊率65．4％。439例SPT均行手术治疗，手术根治性切除率高达97．3％（427／439）。平均肿瘤直径7．8cm（1．5～25．0cm）。394例对肿瘤侵犯转移有记载，80例（20．3％）有恶性表现。418例（95．2％）获得术后随访，平均随访时间34个月（1月～25年）。随访期间403例（96．4％）无瘤存活，4例局部复发，6例发生肝转移，4例因本病病死。结论SPT是一种少见的潜在低度恶性肿瘤，好发于年轻女性，确诊依赖于病理组织学检查。手术是SPT唯一有效的治疗手段，预后良好。

Objective To summarize the experience of diagnosis, treatment and prognosis of solid pseudopapillary tumors of the pancreas （SPT） in China. Methods The Chinese literature from January 1992 to April 2009 in Chinese Journal Full-text Database was systematically searched and a total of 439 cases of SPT from 42 reports were found. Clinical data of these cases were retrospectively analyzed. Results Among 439 patients, 38（8.7% ） were men and 401 （91.3%） were women （male： female ration =- 1： 10.6）. Mean age was 28 years old （range 8 -76 yrs）. The clinical symptoms were recorded in 377 cases, including abdominal pain （35. 3%） , mass （31. 3% ） , disconmfort （ 7. 7%）. 101 patients （26. 8% ） were completely asymptomatic, and the lesions were detected during routine check-up. All of the patients underwent surgical resection. The preoperative misdiagnosis rate was 65.4% （161/246）. The rate of curative resection was 97.3% （427/439）. Mean diameter of the tumor was 7.8 cm （ range 1.5 - 25.0 cm）. Among 394 patients with information on metastases or invasions, 80 patients （20.3 % ） were positive. In all patients, 418 （95.2%） were followed up and the mean follow-up period was 34 months （ range 1 month to 25 years ）. During the follow-up period, 403 （96.4%） patients were alive with no evidence of recurrence or metastases, local recurrence developed in 4 patients, the liver metastases developed in 6 patients, 4 patients died from the disease. Conclusions SPT is a rare and potentially low-grade malignant tumor, and predominantly affect young women. The correct diagnosis depends on the histopathological examination. Radical surgical resection is the only effective treatment for SPT, which usually has an excellent prognosis.