胰腺实性假乳头状肿瘤的临床病理学分析

目的探讨胰腺实性假乳头状肿瘤（solid－pseudopapillary tumor,SPT）的临床特点、病理形态学、免疫组织化学特征及预后。方法对36例SPT患者的临床资料、病理组织学形态及免疫组织化学特征进行研究。结果36例SPT患者临床以腹痛为主要症状。肿块位于胰头15例（41．7％）,胰体5例（13．9％）,胰体尾9例（25．0％）,胰尾7例（19．4％）。组织学上肿瘤主要由实性区和假乳头状区混合构成,瘤细胞围绕纤维血管轴心生长。免疫组织化学结果显示,B．catenin的表达率为94．4％,CD10的表达率为80．6％,CD56和Vim的表达率分别为83．3％和91．7％。32例获得随访资料,随访时间3—96月不等,30例无瘤生存。1例术后复发,1例肝脏转移,均予手术切除,目前无死亡。结论SPT是一种少见的低度恶性肿瘤,可能来源于胰腺多潜能干细胞。免疫组织化学对其诊断和鉴别诊断有重要价值,手术切除后预后好。

Clinicopathologic analysis of solid-pseudopapillary tumor of pancreas

Objective To investigate the clinical features, pathomorphology, immunohistochemical characteristics and prognosis of solid-pseudopapillary tumor （SFF） of pancreas. Methods The clinical presentation, pathological and immunohistochemical characteristics of 36 SPT cases were analyzed. Results In all SPT cases, abdominal pain was the major complain. The tumor was located in pancreatic head in 15 patients （ 41.7% ）, in pancreatic body in 5 patients （ 13.9% ） ,in pancreatic body and tail in 9 patients （ 25.0% ） ,in pancreatic tail in 7 patients （ 19.4% ）. Histologically, the tumor was mainly composed of solid and pseudopapillary structures with a fibrovascular core. Immunohistochemically, the expression of ~-catenin,CD10 ,CD56 and Vim was 94.4% ,80.6% ,83.3% and 91.7%. Thirty-two patients were available for follow-up examination from 3 to 96 months and 30 were alive and disease free. One case had recurrence and one case suffered from liver metastasis. None of them died of tumor after reoperation. Conclusion SPT is an uncommon tumor with low-grade malignancy and may be derived from pancreatic embryonic stem ceils. Immunohistochemistry is very important for the diagnosis and differential diagnosis of SPT. Surgical resection is recommended and the prognosis is better.