胰腺浆液性囊腺瘤9例临床病理分析

Clinicopathological features of serous cystadenoma of the pancreas: An analysis of 9 cases

目的:探讨胰腺浆液性囊腺瘤(serous cystadenoma of the pancreas, SCAP)的临床与病理特征。方法:收集9例诊断为SCAP的临床资料,对其病理特征、特殊染色、免疫组化结果进行分析及相关文献复习。结果:本组8例患者均为女性,1例为男性,发病年龄为26～65岁,平均年龄为52岁。临床主要表现为不同程度的腹胀、腹痛。其中微囊型7例(占77.8%),寡囊型2例(占22.2%)。组织学上,囊壁由单层立方上皮衬覆,细胞相对一致,胞浆透明,核无异型性和无核分裂。免疫组化:EMA、CK7、CK8、CK18及CK19均(+),Ki-67 (+,1%～3%),CEA、Syn、P53及CgA均(-)。特殊染色:PAS (+)。结论:SCAP是胰腺外分泌腺罕见肿瘤,临床多无明显症状,诊断该病多依靠病理组织学检查,故准确掌握该病的病理特征十分重要。

Objective: To explore the clinicopathological features of serous cystadenoma of the pancreas (SCAP). Methods: We collected the clinical data of 9 cases diagnosed as SCAP, analyzed their pathological features, special staining results, and immunohistochemical results, and reviewed the relevant literature. Results: Eight patients were female and one was male. The age of patients ranged from 26 to 65 years, with a mean age of 52. The main clinical manifestations were varying degrees of abdominal distension and abdominal pain. Among the cases, 7 (77.8%) were microcystic adenoma and 2 (22.2%) were oligocystic adenoma. Histologically, the cyst wall is lined by a single layer of cuboidal epithelial cells, which were relatively uniform and had clear cytoplasm, with no nuclear atypia or division. The immunohistochemical results were as follows: EMA (+), CK7 (+), CK8 (+), CK18 (+), and CK19 (+);Ki-67 (+, 1%-3%);CEA (-), Syn (-), p53 (-), and CgA (-). PAS (+) was found in special staining. Conclusion: SCAP is a rare type of pancreatic exocrine gland tumor. A lack of obvious clinical symptoms makes the diagnosis dependent on histopathological examination. So it is essential to master the accurate pathological features of this disease.