胰腺囊性病变110例临床病理分析

Clinicopathological analysis of 110 cases of pancreatic cystic lesions

〕目的探讨胰腺囊性病变的临床与病理特征。方法检索2014年1月—2021年9月西南医科大学附属医院病理科诊断的胰腺囊性病变病例,共125例。在2名高职称病理医生指导下,根据其组织学形态,最终确诊纳入病例110例,并对病例进行免疫组织化学检测。最后收集临床资料,整理数据,总结、分析胰腺囊性疾病的临床及病理特征。结果本组胰腺囊性疾病共110例,年龄4岁~76岁,平均年龄48岁,男性38例,女性72例,临床上大多无症状或表现为不同程度的腹胀、腹痛,影像学检查常常提示囊性或囊实性病变。所有病例均行手术切除,术后病理诊断根据2019版WHO消化系统肿瘤分类,包括假性囊肿37例,导管内乳头状黏液性肿瘤(intraductalpapillarymucinousneoplasm,IPMN)14例,黏液性囊性肿瘤(mucinouscysticneoplasm,MCN)12例,浆液性囊腺瘤(serouscystadenoma,SCA)24例,实性-假乳头瘤(solid-pseudopapillaryneoplasm,SPN)23例。结论胰腺囊性疾病发病年龄广,多见于中年人,女性稍多。胰腺囊性疾病临床无特异性,影像具有一定提示作用,确诊主要依靠病理组织学检查,故准确掌握该组病变的病理特征十分重要,对于提高影像诊断精确度及术后规范化治疗具有重要意义。

Objective To investigate the clinical and pathological features of pancreatic cystic lesions.Methods We retrieved 125 cases of pancreatic cystic lesions diagnosed by the Department of Pathology,Affiliated Hospital of Southwest Medical University from January 2014 to September 2021.Under the guidance of two senior pathologists,110 cases were finally included in the study based on their histological morphology,and immunohistochemical tests.Clinical data were collected,and the data were summarized and analyzed to determine the clinical and pathological characteristics of pancreatic cystic diseases.Results There were a total of 110 cases of pancreatic cystic diseases in this group,with ages ranging from 4 to 76 years and a mean age of 48 years.There were 38 males and 72 females.Most patients were asymptomatic or presented with varying degrees of abdominal distension and abdominal pain.Radiological examinations often suggested cystic or cystic-solid lesions.All cases underwent surgical resection,and postoperative pathological diagnoses were made according to the 2019 WHO classification of digestive system tumors,including 37 cases of pseudo-cysts,14 cases of intraductal papillary mucinous neoplasms(IPMN),12 cases of mucinous cystic neoplasms(MCN),24 cases of serous cystadenomas(SCA),and 23 cases of solid-pseudopapillary neoplasms(SPN).Conclusion Pancreatic cystic diseases can occur at a wide range of ages but are more common in middle-aged individuals,with a slight predominance in females.Clinical symptoms of pancreatic cystic diseases are nonspecific,and imaging plays a certain suggestive role.However,accurate diagnosis relies primarily on pathological histological examination.Therefore,it is essential to accurately grasp the pathological characteristics of this group of lesions,which is crucial for improving the accuracy of imaging diagnosis and standardizing postoperative treatment.