Clinical and Pathological Features of Solid Pseudopapillary Neoplasms of the Pancreas at a Single Institution
Clinical and Pathological Features of Solid Pseudopapillary Neoplasms of the Pancreas at a Single Institution
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DOI：
10.1159/000363420
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发表时间：
2014-06
影响因子：
2.7
通讯作者：
Shuji Suzuki;T. Hatori;T. Furukawa;K. Shiratori;Masakazu Yamamoto
中科院分区：
文献类型：
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作者：
Shuji Suzuki;T. Hatori;T. Furukawa;K. Shiratori;Masakazu Yamamoto
目的：本研究旨在探讨单一机构胰腺实性假乳头状肿瘤(SPN)的临床病理特征及外科治疗。方法：我们调查了1994-2012年间因SPN而接受手术治疗的34例患者(男5例，女29例)。结果：58.8%的患者无临床症状。肿瘤平均直径为42.7 mm。所有肿瘤均经R0切除成功切除。病理上十二指肠侵犯占5.9%，胰腺浆膜侵犯占2.9%，但无淋巴结转移。放射学表现为钙化39.4%，包膜形成51.5%，囊性成分69.7%，固体成分93.9%，内出血36.4%。免疫组织化学显示，神经元特异性烯醇化酶阳性率为100%，β-连环蛋白胞核聚集率为100%，CD10值为78.8%。中位随访期(67个月)无复发报告。至于性别差异，在所研究的特征中，放射成像中的囊性成分是唯一有意义的发现(p=0.01)。结论：对于SPN患者，即使对于局部侵袭性肿瘤，采用适当的手术方式切除R0似乎也是足够的。除了影像上的囊性成分外，性别间无显著差异。
Aims: The aim of this study was to determine the clinicopathological features and surgical management of solid pseudopapillary neoplasms (SPNs) of the pancreas at a single institution. Methods: We investigated 34 patients (5 males and 29 females) who underwent surgery for pathologically confirmed SPNs between 1994 and 2012. Results: Clinical symptoms were absent in 58.8% of the patients. The median tumor diameter was 42.7 mm. All tumors were successfully removed by R0 resection. Pathologically, 5.9% had duodenum invasion and 2.9% had pancreatic serosal invasion, but there was no lymph node metastasis. Radiological findings showed calcification in 39.4% of the patients, capsule formation in 51.5%, cystic components in 69.7%, solid components in 93.9% and internal bleeding in 36.4%. Immunohistochemically, neuron-specific enolase was positive in 100% of the patients, nuclear accumulation of β-catenin in 100% and CD10 in 78.8%. There were no recurrences reported at the median follow-up (67 months). Regarding gender differences, the cystic component in radiological imaging was the only significant finding among the features studied (p = 0.01). Conclusions: R0 resection with appropriate procedures appears to be sufficient for patients with SPNs, even for locally invasive tumors. There were no significant differences between genders except for the cystic component on radiological imaging.