胰腺黏液性囊性肿瘤42例诊治分析

Mucinous cystic neoplasms of pancreas： an analysis of 42 patients

目的探讨胰腺黏液性囊性肿瘤的临床病理特征、诊断和治疗。方法回顾性分析天津肿瘤医院收治的42例胰腺黏液性囊性肿瘤临床病理资料，采用X2检验、t检验进行分组比较。结果患者平均年龄53．1（29～78）岁，女性患者32例，占76．2％。根据有无临床症状分组，两组在肿瘤大小、肿瘤部位、手术方式、手术时间、是否与周围组织粘连及病理类型方面差异有统计学意义。根据病理类型分组，三组在年龄、肿瘤标志物、肿瘤部位、手术方式、手术时间、是否与周围组织粘连、是否术中输血及术后住院时间方面，差异有统计学意义。囊腺瘤组随访期无复发，囊腺癌组术后复发的时间为0～50（16．4±16．8）个月，术后生存期为3～58（22．9±18．6）个月。结论黏液性囊性肿瘤好发于中年女性，出现明显临床症状提示肿瘤恶变的可能，早期手术切除是黏液性囊性肿瘤治疗的关键。

Objective To study the clinicopathological characteristics, diagnosis and treatment of patients with mucinous cystic neoplasms （MCNs） of the pancreas. Methods The clinical data of 42 patients with mutinous cystic neoplasms of pancreas were retrospectively analyzed. Chi-square test and independent sample t-test were used for statistical analysis. Results The mean age of the patients was 53.1 yeas （ranged from 29 to 78 y）. There were 32 female （76.2%）. The patients were divided into two groups according to symptoms （the symptomatic group and the asymptomatic group）. There were significant differences in tumor size, tumor location, operation type, operation time and adhesions with the surrounding tissues between the 2 groups of patients. The patients were then divided into three groups according to pathological type. There were significant differences in age, tumor marker, tumor location, operation type, operation time, adhesions with the surrounding tissues, operative blood loss, and postoperative hospital stay among the 3 groups of patients. There was no tumour re- currence in the patients with cystadenoma. Patients with cystadenocarcinoma developed tumor recur- rence at a mean of 16.4 months （range, 0-50） and died of tumor recurrence even after radical surgery at a mean of 22.9 months （range, 3-58）. Conclusion MCNs were seen most commonly in middle- aged women. The presence of symptoms was a sign of malignancy. Resection of the tumor in the early stage is the key in dealing with MCNs.