52例胰腺浆液性囊腺瘤临床病理分析

目的：探讨胰腺浆液性囊腺瘤（SCAP）的临床病理特点。方法：对52例SCAP患者进行临床资料、病理学检查统计，并随访其中20例。结果：52例SCAP患者中女44例（84．6％），男8例（15．4％）；平均年龄59岁；有临床症状者33例（63．5％）；肿瘤位于胰体尾部者36例（69．2％）。SCAP呈囊性，囊壁内衬扁平、立方上皮细胞，胞质透亮，细胞无异型。按WHO标准分类，52例中属浆液性微囊性腺瘤者45例（86．5％），浆液性寡囊性腺瘤7例（13．5％）。肿瘤细胞PAS染色阳性。52例肿瘤细胞广谱细胞角蛋白（AEI／AE3）、细胞角蛋白7（CK7）、细胞角蛋白19（CK19）全部阳性表达；CA19—9、CEA部分阳性表达；胰岛素、MIB-1阴性。2例电镜超微结构显示肿瘤细胞腔面有微绒毛，胞质内含有糖原。20例患者经4个月到8年不等的随访，未发现复发及转移。结论：SCAP好发于老年女性患者，肿瘤多位于胰体尾部，近2／3的患者有临床症状。SCAP来源于胰腺导管上皮，为良性肿瘤，患者预后好。

Clinicopathologic analysis of 52 cases of serous cystadenoma of the pancreas

Objective To study the clinicopathologic features of serous cystadenoma of the pancreas(SCAP).Methods Clinical data and pathologic findings of 52 cases of SCAP were analyzed,of which 20 had been follow-up.Results Forty-four(84.6%) were female and 8(15.4%) were male,with an average age of 59 years.Clinical symptoms were found in 33(63.5%) cases,and SCAP in 36(69.2%) cases located in body and tail of the pancreas.All tumors were cystic,lined with flattened or cuboidal epithelial cells that had clear cytoplasm,and pleomorphism was seen.According to the criteria of WHO,45(86.5%) were microcystic adenoma and 7(13.5%) were oligocystic adenoma.PAS was positive.All 52 cases showed positive staining for AE1/AE3,CK7 and CK19,but negative for insulin and MIB-1.CA19-9 and CEA were positive in some cases.Electromicroscopy in 2 patients showed microvilli on the luminal surface of tumor cell and glycogen in cytoplasm.Recurrence or metastasis were not found in 20 patients followed-up for 4 months to 8 years.Conclusions SCAP was seen preferably in elderly women,and most of them located in body and tail of the pancreas,and nearly 2/3 patients had clinical symptoms.SCAP is originated from pancreatic ductal epithelial cell,and is a benign tumor with good prognosis.