胰腺囊实性假乳头状肿瘤9例临床分析并文献复习

背景与目的:胰腺囊实性假乳头状肿瘤(solid-cysticpseudopapillarytumorofthepancreas,SCPT)临床上较为少见,其诊断与治疗目前分歧很大。本研究拟探讨SCPT的诊断原则与治疗方法。方法:回顾性分析1997年1月至2005年2月西安交通大学医学院第一附属医院肝胆外科收治的9例SCPT患者的临床资料,并复习文献,对该病的发病、临床特点和治疗进行分析总结。结果:9例患者中,中青年女性占77.8%,肝功能、血清淀粉酶以及肿瘤系列标志物检查如CEA、CA199均正常。B超诊断准确率22.2%,CT诊断准确率77.8%,肿瘤发病部位以胰体尾部多见,大多数患者行肿瘤局部切除术。患者术后恢复好,均未发生转移,至2005年10月止,仍全部生存,生存期6个月至8年。结论:SCPT临床病例少见,以中青年女性发病为主,部位多见于胰体尾部,血清淀粉酶、CEA、CA199测定无特异性,但CT检查具有诊断价值。CT诊断联合应用细针穿刺取病理,可提高其诊断准确性。SCPT手术效果好。

Clinical analysis of 9 cases of solid-cystic pseudopapillary tumor of the pancreas with literature review

BACKGROUND & OBJECTIVE: Solid-cystic pseudopapillary tumor of the pancreas (SCPT) is a rare type of pancreatic tumor with low grade of malignancy. Its diagnosis and treatment remain controversial. This study was to discuss the diagnosis criteria and treatment strategy of SCPT. METHODS: Clinical data, including general history, medical history, treatment history and treatment outcome, of 9 SCPT patients, treated in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi'an Jiaotong University from Jan. 1997 to Feb. 2005, were analyzed retrospectively, and the related literature was reviewed to summarize the clinical characteristics, diagnosis, and treatment of SCPT. RESULTS: Among the 9 patients, 7 (77.8%) were women under 44 years old. The laboratory tests of liver function, serum amylase, and CEA, CA199 were normal. The accurate diagnosis rate of ultrasound was 22.2%, while that of CT was 77.8%. Most patients received local resection of the tumor. All patients were followed-up till Oct. 2005 and no metastasis was detected. CONCLUSIONS: SCPT is a rare disease with good prognosis. It occurs mainly in young women. In spite of unspecific laboratory tests, CT and fine needle aspiration method are useful to diagnose the disease. Based on literatures, operation could achieve satisfactory efficacy for SCPT patients.