Tumor Size and Location Correlate With Behavior of Pancreatic Serous Cystic Neoplasms
Tumor Size and Location Correlate With Behavior of Pancreatic Serous Cystic Neoplasms
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DOI：
10.1038/ajg.2011.117
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发表时间：
2011-08-01
影响因子：
9.8
通讯作者：
Giday, Samuel
中科院分区：
文献类型：
--
作者：
Khashab, Mouen A.;Shin, Eun Ji;Giday, Samuel
胰腺浆液性囊性肿瘤（SCN）大多数是良性的。然而，这些肿瘤可能会引起症状，很少有侵略性。识别与症状性或侵袭性SCN相关的因素可能有助于管理决策。本研究的目的是确定变量预测侵略性SCNs.METHODS：前瞻性病理数据库查询SCNs手术切除在约翰霍普金斯医院。如果肿瘤侵入周围结构和/或血管或转移至淋巴结或远处器官，则认为肿瘤具有侵袭性。性别，肿瘤大小，肿瘤位置，有无症状和肿瘤的行为进行了检查，使用Fisher精确检验，逻辑回归，和多变量analysis.Results：共257例患者进行手术切除的SCN的协会。平均肿瘤直径为4.9 cm。肿瘤位于胰头（HOP）与症状相关（比值比（OR）1.87，95%置信区间（CI）1.1-3.3）。计算机断层扫描（CT）预测约四分之一的患者诊断为SCN。13个肿瘤（平均10.5 cm）被认为是侵袭性的。多变量分析显示，肿瘤直径（OR 1.53，95%CI 1.24-1.89）和肿瘤在胰头的位置（OR 10.44，95%CI 1.73-63.04）是独立相关的侵略behaviors.CONCLUSIONS：我们描述了最大的病例系列的患者病理证实的SCN。CT对SCNs的术前诊断价值不高。大肿瘤大小和头部位置预测攻击行为。在SCN患者的管理中应考虑这些因素。
OBJECTIVES: The majority of pancreatic serous cystic neoplasms (SCNs) are benign. However, these neoplasms can cause symptoms and rarely can be aggressive. Identification of factors associated with symptomatic or aggressive SCNs may aid management decisions. The aim of this study was to identify variables that predict aggressive SCNs.METHODS: Prospective pathology database was queried for SCNs that were surgically resected at Johns Hopkins Hospital. Tumors were considered aggressive if they invaded surrounding structures and/or vessels or if they metastasized to lymph nodes or distant organs. The associations of gender, tumor size, and tumor location, with the presence or absence of symptoms and tumor behavior were examined using Fisher's exact test, logistic regression, and multivariate analyses.RESULTS: A total of 257 patients with SCNs underwent surgical resection. Mean tumor diameter was 4.9 cm. Tumor location in the head of pancreas (HOP) was associated with symptoms (odds ratio (OR) 1.87, 95% confidence interval (CI) 1.1-3.3). Computed tomography (CT) predicted the diagnosis of SCN in approximately a quarter of patients. Thirteen tumors (mean 10.5 cm) were considered aggressive. Multivariate analysis showed that tumor diameter (OR 1.53, 95% CI 1.24-1.89) and location of tumor in pancreatic head (OR 10.44, 95% CI 1.73-63.04) were independently associated with aggressive behavior.CONCLUSIONS: We describe the largest case series of patients with pathologically proven SCNs. CT performed poorly in preoperative diagnosis of SCNs. Large tumor size and head location predicted aggressive behavior. These factors should be considered in the management of patients with SCN.