70例胰腺肿瘤的临床病理学特征分析

Clinicopathologic Analysis of 70 cases of pancreatic tumor

目的探讨胰腺肿瘤临床病理学特征、免疫组织化学染色及鉴别诊断。方法应用形态学观察、免疫组织化学染色回顾性分析70例胰腺肿瘤的临床及病理学特点。结果①70例胰腺肿瘤中患者年龄14-84岁,平均年龄53.3岁;女性40例(57.1%),男性30例(43.9%);肿瘤位于胰头42例(60.0%),胰体10例(14.3%),胰尾18例(25.7%)。②70例胰腺肿瘤中30例导管腺癌(42.9%),17例实性假乳头状肿瘤(24.3%),12例粘液性囊性肿瘤(17.1%),3例浆液性囊腺瘤(4.3%);4例神经内分泌肿瘤(5.7%);2例导管内乳头状粘液癌(2.9%),1例胰腺低分化粘液表皮样癌(1.4%);1例继发性黑色素瘤(1.4%)。③47例(67.1%)患者有腹胀、腹痛、上腹不适症状,41例(58.5%)有黄疸。④胰腺恶性肿瘤病理分期:病理分期I期27例,II期25例,III期5例,IV期2例。⑤在17例胰腺实性假乳头状肿瘤中,男性患者1例,占5.8%,对其中6例患者进行预后随访3-36个月,均无转移及复发。⑥在12例粘液性囊性肿瘤中,男性患者4例。结论 70例胰腺肿瘤中导管腺癌发病率最高,其次是胰腺实性假乳头状肿瘤,粘液性囊性肿瘤占第3位,其中胰腺实性假乳头状肿瘤以年轻女性为主,也可发生于男性,随访无复发及死亡病例。粘液性囊性肿瘤,发生于男性患者并不罕见。发现1例胰腺原发性低分化粘液表皮样癌,属罕见病例,预后较差。

Objective To investigate the clinicopathologic characteristics,immunohistochemical staining and differential diagnosis of pancreatic tumors.Methods The clinicopathological features were retrospectively analyzed in 70 cases of pancreatic tumors by morphologic and immuhohistochemical examination.Results ①The patients of 70 cases of pancreatic tumors,40 females（57.1%） and 30 males（43.9%）,aged from 14.0 to 84.0 years,with the average of 53.3 years.42 cases of the tumors（60.0%） were located in pancreatic head,10 cases（14.3%） were located in pancreatic body and 18 cases（25.7%） were located in pancreatic tail.②Among 70 cases of pancreatic tumors,there were 30 cases of ductal adenocarcinoma（42.8%）,17 cases of Solid-pseudopapillary neoplasms（24.3%）,12 cases of Mucinous cystic neoplasms（17.1%）,three cases of serous cystadenoma（4.3%）;four cases of neuroendocrine tumors（5.7%）;two cases of intraductal papillary mucious carcinoma（2.9%）,1 case of pancreatic poorly differentiated mucoepidermoid carcinoma（1.4%）,1 case of secondary melanoma（1.4%） respectively.③47 patients（67.1%） presented with abdominal distension,abdominal pain and abdominal discomfort,41 patients（58.5%） presented with jaundice.④Pathological stage of malignant pancreatic tumors included 27 cases in stage I,25 cases in stage II,5 cases in stage III and two cases in stage IV.⑤There was one male patient in 17 cases of Solid-pseudopapillary neoplasms,accounting for 5.8%.6 cases were followed-up from？3 months to 36 months and there were no metastasis and recurrence cases after operation.⑥There were 4 male patients in 12 cases of Mucinous cystic neoplasms,accounting for 33.3%.Conclusion Ductal adenocarcinoma is the most common histological subtype of pancreatic tumors,solid-pseudopapillary neoplasms is in the second place,and mucinous cystic tumors in the third.Solid-pseudopapillary neoplasms occurs predominantly in adolescent girls and young women and can also occur in men.There are no metastasis and recurrence cases after following-up.Mucinous cystic neoplasms of the pancreas are not rare in men.One very rare case of primary poorly differentiated mucoepidermoid carcinoma is found in pancreas