胰腺黏液性囊性肿瘤诊治分析

目的?探讨胰腺黏液性囊性肿瘤（MCN）的诊断与治疗。方法 对我院2008年1月至2014年12月49例经术后病理证实为MCN的患者临床资料进行回顾性分析。结果?49例MCN患者中，伴异型性增生39例，伴浸润性癌10例。伴异型性增生的MCN患者中女30例，男9例，平均年龄（46.2±12.7）岁，肿瘤位于胰头部12例，胰体部及胰体尾部18例，胰腺尾部9例；肿瘤平均直径（5.3±3.3）cm。伴浸润性癌的MCN患者中女8例，男2例，平均年龄（51.3±14.7）岁；肿瘤位于胰头部4例，位于胰体尾6例；肿瘤平均直径（7.8±1.8）cm。?所有MCN患者均行手术治疗，结合术后病理切缘情况，47例得到根治性切除，2例切缘为阳性（均伴有浸润性）。肿瘤直径、CA19-9升高、肿瘤内乳头状结构在伴有浸润性癌和伴有异型性增生的MCN患者中具有统计学差异（P＜0.05）。49例均获得随访，随访时间为5～85个月，中位随访时间46.3个月。伴有异型性增生的MCN患者中未见肿瘤复发或转移；伴有浸润性癌的MCN患者中死亡3例，余患者未见肿瘤复发或转移。结论?术前影像学检查对于MCN的诊断有着重要的意义。MCN手术切除后，预后较好，但对于伴有浸润性癌的MCN患者，即使行根治性切除，术后仍需密切随访。

Diagnosis and treatment of mucinous cystic neoplasm in pancreas

Objective To investigate the diagnosis and treatment of mucinous cystic neoplasm (MCN) in pancreas. Methods The clinical data of 49 patients with MCN admitted into our hospital from Jan. 2008 to Dec. 2014 were retrospectively analyzed. Results Of the 49 patients, 39 were diagnosed as MCN with dysplasia and 10 were MCN with invasive carcinoma. Among the patients with dysplasia, 30 cases were female and 9 were male, with the average age of (46.2±12.7) years, 12 cases with tumors located in the pancreatic head, 18 cases in body and tail, 9 cases in tail, with the average tumor size of (5.3±3.3) cm. Among the patients with invasive carci-noma, 8 cases were female and 2 were male, with the average age of (51.3±14.7) years, 4 cases with tumors were found in the pancreatic head, 6 cases in body and tail, with the average tumor size of (7.8±1.8) cm. All patients underwent surgical treatment and were validated with pathological examination. Forty-seven cases received radi-cal resection, 2 case with invasive carcinoma received palliative surgery with positive margin. There was signifi-cant difference (P<0.05) in tumor size, elevated CA19-9 and mural nodules between MCN cases with dysplasia and MCN cases with invasive carcinoma. 49 patients were followed-up, after a median follow-up of 46.3 months (range 5 to 85 months), all patients with dysplasia survived without tumor recurrence or malignant transforma-tion. Death was found in 3 cases with invasive carcinoma, the rest of patients survived without tumor recurrence or malignant transformation. Conclusion Preoperative radiological examination is important for diagnosis and differential diagnosis of MCN in pancreas. The prognosis of MCN is good after complete resection, but for MCN with invasive carcinoma, even with complete resection, close follow-up is recommended.