原发性脾肿瘤63例诊治分析

Diagnosis and treatment of primary splenic tumor： an analysis of 63 cases

目的 回顾分析原发性脾肿瘤的临床病理资料及临床诊治结果,以提高对脾肿瘤的认识.方法 对天津肿瘤医院15年间收治的63例经病理证实的脾原发肿瘤临床资料进行分析.结果 63例均经手术治疗,并经病理证实.其中单纯脾切除21例,脾＋胰体尾切除27例,脾＋胰体尾切除＋其他脏器联合切除15例.良恶性之比为1∶2.原发性脾恶性肿瘤中以恶性淋巴瘤最常见（39/42）,恶性肿瘤术后5年生存率为35.9%（15/42）.结论 脾脏肿瘤的诊断主要依靠临床表现、影像学检查及细针穿刺活检;良恶性鉴别可根据CT、血管造影;早期诊断、根治手术和综合治疗是改善脾脏恶性肿瘤预后的重要手段,但目前治疗仍需规范.

Objective To summarize the experience in diagnosis and treatment of primary splenic neoplasm （PSN） to promote understanding of the disease. Methods The clinical data of all admitted patients with PSN treated in this hospital from February 1989 to February 2004 were retrospectively analyzed. Results A total of 63 patients were treated by surgery and pathologically confirmed as PSN. Twenty-one patients were treated by splenectomy alone. Twenty-seven patients underwent distal pancreatectomy and splenectomy. Fifteen patients received splenectomy combined with excision of tumor, the 5-year survival rate was 35.9%（15/42）. Conclusion PSN should be diagnosed mainly according to clinical manifestations, image examination, and fine needle aspiration biopsy. CT and angiography play an important role in the identification of benign and malignant splenic mass. Early diagnosis, radical resection and comprehensive treatment are important for improving the prognosis of PSN.