胰腺浆液性囊腺瘤临床病理特点分析

Clinico-pathological characteristics of serous cystadenoma of pancreas

目的探讨胰腺浆液性囊腺瘤（serous cystadenoma of the pancreas,SCAP）的临床病理学特点。方法收集四川省人民医院病理科2010年1月至2014年6月12例诊断为SCAP患者的病历资料,分析SCAP的临床特点及病理学特征。结果本组12例中女性居多（83.3%）,发病年龄36～73岁,平均年龄53岁。5例为体检时偶然发现,就诊时无明显临床症状。7例有不同程度的腹痛、腹胀。镜下见肿瘤由大小不等的囊腔组成,囊壁内衬扁平或富于糖原的立方上皮,细胞形态一致无异型性,胞质透明,核圆形或卵圆形,未见核分裂象,间质可见纤维组织分隔。免疫表型：12例肿瘤细胞CK7、CK19、EMA均阳性;10例不同程度地表达α-inhibin;Ki-67指数均为低表达,阳性率1%～2%。所有患者均采用手术切除治疗。随访3～55个月,12例患者均存活,无复发。结论 SCAP发病率低,影像学检查、免疫组化等辅助检查有助于诊断及鉴别诊断。患者手术切除肿瘤后预后好。

Objective To investigate the clinico-pathological features of serous cystadenoma of pancreas（SCAP）.Methods Twelve cases of SCAP were collected from Jan.2010 to Jun.2014 at department of pathology of Sichuan Provincial People＇s Hospital.The clinical characteristics and pathological features were retrospectively analyzed.Results Of the 12 cases,there were 2 males and 10 females.The age of patients ranged from 36 to 73 years old and with a mean age of 53 years old.Five cases were found on routine medical examinations without clinical symptoms.Seven cases had varying degrees of abdominal pain or abdominal distension.Four cases were in pancreatic head,1 in pancreatic body,3 in pancreatic tail,and 4 in pancreatic body and tail.Six patients were found to be accompanied with cystic diseases of liver and/or kidney.Under microscopic examination,the tumors were found to compose of multiple small cysts lined by flattened or cuboidal epithelial cells containing abundant glycogen.Tumor cells were consistent with clear cytoplasm and round or oval shaped nucleus,and without nuclear mitotic.The stroma of the tumors was found to contain fibrous tissue.By using immunohistochemical staining,the tumor cells were positive for CK7,CK19 and EMA in all cases while α-inhibin was positive in varying degrees in 10 cases.Ki-67 was weak expressed with positive rate from 1% to 2%.All patients were treated with mass resection,and lived without recurrence during the follow-up periods from 3 to 55 months.Conclusion Serous cystadenoma of pancreas is a rare tumor.The diagnosis and differential diagnosis mainly depends on histopathological and immunohistochemical examinations combined with radiological examinations.This tumor has a good prognosis after surgical removal.