437例胰腺肿瘤临床病理构成分析

Pancreatic tumors:Clinicopathological analysis in 437 cases

目的:研究初次手术切除胰腺肿瘤的病理类型构成,为胰腺肿瘤的早期防治提供临床参考。方法:收集弋矶山医院2012年1月~2019年12月所有胰腺肿瘤初次手术切除的标本。经HE染色、免疫组化(Envision二步法)辅助诊断、阅片,排除转移性胰腺肿瘤,获得原发于胰腺的肿瘤共437例,分析性别、年龄及病理分型,并与其他研究进行比较。结果:437例胰腺肿瘤中导管腺癌304例(69.6%),黏液性囊性肿瘤24例(5.5%),浆液性囊性肿瘤22例(5.0%),实性假乳头状肿瘤17例(3.9%),神经内分泌肿瘤20例(4.6%),腺泡囊性变11例(2.5%),上皮内瘤变8例(1.8%),神经内分泌癌5例(1.1%),导管内乳头状黏液性肿瘤3例(0.7%),腺泡细胞癌3例(0.7%),肉瘤样癌3例(0.7%),混合型神经内分泌肿瘤-非神经内分泌肿瘤3例(0.7%),其他类型14例(3.2%)。其中以导管腺癌最为常见,其余较多见的类型依次为黏液性囊腺肿瘤、浆液性囊腺肿瘤、神经内分泌肿瘤、实性假乳头状肿瘤,余下类型例数均较少。男性243例,女性194例,男女性别比为1.25∶1,男性更为多见。年龄20~84岁,中位年龄63岁。结论:胰腺肿瘤的病理类型最常见的为导管腺癌,男性较女性更为多见,各型在不同地域的分布具有差异性。

Objective:To investigate the pathological types of pancreatic tumors by primary surgical resection for clinical evidence in prevention and treatment of this neoplasm in early stage.Methods:The specimens were obtained from all patients of pancreatic tumors undergone primary surgical resection in our hospital between January 2012 and December 2019,and subjected to differentiation diagnosis by reviewing the histological sections after HE staining and immunohistochemistry(EnVision Detection System,two-step procedures)to exclude metastatic pancreatic tumors.Finally,a total of 437 primary tumors of the pancreas were identified,and analyzed regarding the genders,age and pathological types.And the findings were compared with other studies.Results:In the 437 cases of pancreatic tumors,304 were ductal adenocarcinoma(69.6%),24 mucinous cystic neoplasm(5.5%),22 serous neoplasia(5.0%),17 solid pseudopapillary neoplasm(3.9%),20 neuroendocrine neoplasms(4.6%),11 acinar cystic transformation(2.5%),8 intraepithelial neoplasia(1.8%),5 neuroendocrine carcinoma(1.1%),3 intraductal papillary mucinous neoplasm(0.7%),3 acinar cell carcinoma(0.7%),3 sarcomatoid carcinoma(0.7%),3 MiNETs(0.7%),and 14 other types(3.2%).Ductal adenocarcinoma was the most common type,followed by acinar cystic transformation,serous neoplasia,neuroendocrine neoplasm and solid pseudopapillary neoplasm.The remaining types were uncommon.243 of the patients were males,and 194 females,with a male to female ratio being 1.25∶1.The patient′s age ranged from 20 to 84 years,with a median age of 63 years.Conclusion:Pancreatic tumor is dominated by ductal adenocarcinoma,with more prevalence in males than females,yet pathological type varies a lot in population from different regions.