胰腺实性假乳头状瘤的诊断与治疗

Diagnosis and surgical treatment of solid pseudopapillary tumor of the pancreas

目的 总结胰腺实性假乳头状瘤的诊断与治疗经验.方法 回顾性分析天津医科大学附属肿瘤医院2006年1月至2011年10月收治的24例胰腺实性假乳头状瘤患者的临床病理资料.结果 本组患者中男2例、女22例,中位年龄27.5岁（12～51岁）.24例患者中11例肿瘤位于胰头,5例位于胰体,4例位于胰尾,3例位于胰体尾,1例位于胰颈体部.肿瘤直径平均为6.4cm（2.0～12.0 cm）.该病无特异性临床表现,术前诊断主要依赖于彩超、CT、MR等影像学检查.所有患者均行手术切除治疗,经术后病理证实为胰腺实性假乳头状瘤.术后随访时间为2～55个月,中位随访时间27.2个月,23例患者无瘤生存,l例患者术后复发,带瘤生存. 结论 胰腺实性假乳头状瘤是一种少见的低度恶性胰腺肿瘤,多发于青年女性,完整手术切除可获得较好的预后.

Objective To evaluate the diagnosis and therapy of solid pseudopapillary tumor of the pancreas （SPTP）.Methods From January 2006 to October 2011,the clinicopathological data of 24 SPTP patients diagnosed and surgically treated at Tianjin Medical University Cancer Hospital were analyzed retrospectively.Results There were 22 women and 2 men,the median age was 27.5 years old,with a range from 12 to 51 years.The most common tumor localization were at the head of the pancreas （ 11 patients,45.7% ）,followed by the body （5 patients,20.8% ）,the tail （4 patients,16.7% ）,the body and the tail （3 patients,12.5% ） and the neck （one patient,4.2% ）.Clinical symptoms were nonspecific and the preoperative diagnosis of SPTP depended on imaging study such as ultrasonography,CT and MR.All patients were treated surgically and the correct diagnosis was made according to pathology after surgery.In a follow-up ranging from 2 to 55 months（ median 27.2 months）,23 cases were alive with no evidence of disease recurrence,one patient was alive with tumor recurrence.Conclusions SPTP was a less common neoplasm with low-grade malignancy,occurring mainly in young women.Complete tumor resection results in satisfactory prognosis.