胰腺实性假乳头状瘤10例临床分析

Solid Pseudopapillary Tumor of Pancreas:Clinical Analysis of 10Cases

目的：探讨胰腺实性假乳头状瘤（SPTP）的临床特征、治疗及其预后。方法回顾性分析经手术及病理检查证实的10例 SPTP 患者的临床资料。结果10例患者术后恢复良好，均未出现胆瘘、胰瘘及糖尿病等并发症。8例患者行免疫组织化学检测，其中 NSE 阳性8例，阳性表达率为100．0％；Syn、Vim 和 PR 阳性各7例，阳性表达率均为87．5％；Ki-67部分阳性6例，阳性表达率为75．0％；CK 局灶阳性4例，阳性表达率为50．0％；CD99阳性3例，阳性表达率为37．5％；CK18局灶阳性2例，CD10阳性2例，阳性表达率均为25．0％；CD56、α-AT、α-ACT 和CgA 阳性各1例，阳性表达率均为12．5％；EMA 阴性8例，阴性表达率为100．0％。2例患者未行免疫组织化学检测。10例患者随访时间为6～72个月，均未发现肿瘤复发及转移。结论SPTP 是一种潜在低度恶性肿瘤，可能来源于胰腺胚胎多能干细胞，手术切除是首选的治疗方法。

Objective To investigate the clinical features,treatment and prognosis of solid pseudopapillary tumor of the pancreas（SPTP）.Methods The clinical data of 10 patients with SPTP confirmed by surgery and pathological examination were retrospectively analyzed.Results All patients recovered well postoperatively.No patients had biliary fistula,pancreatic fistula,diabetes and other complications.Among the 8 patients who received immunohistochemical determination,results showed NSE positive in 8（100.0%）,Syn positive in 7（87.5%）,Vim positive in 7 （87.5%）,PR positive in 7（87.5%）,Ki-67 positive in 6（75.0%）,CK positive in 4（50.0%）,CD99 positive in 3（37.5%）,CK18 positive in 2（25.0%）,CD10 positive in 2（25.0%）,CD56 positive in 1（12.5%）,α-AT positive in 1 （12.5%）,α-ACT positive in 1 （12.5%）,CgA positive in 1 （12.5%）,and EMA negative in 8（100.0%）.The 2 patients did not undergo immunohistochemistry determination.After 6-72 months of follow-up,no recurrence and metastasis were observed in all patients.Conclusion SPTP is a kind of potential low-grade malignant tumor,which probably originate from the pancreatic embryonic pluripotent stem cells.Surgical resection is the preferred treatment for SPTP.