胰腺腺泡细胞癌的临床及病理特点分析

目的：分析探讨胰腺腺泡细胞癌的临床及病理特点。方法：回顾性分析北京协和医院10年来诊治的胰腺腺泡细胞癌病例资料。结果：共收集有完整资料的病人6例，临床多表现为腹痛、体重减轻、背痛及恶心呕吐等。肿瘤位于胰头2例，钩突1例，胰体／尾3例。切除标本的主要病理特点为，肿块直径均较大，平均7．00cm×5．92cm×5．00cm，3例有完整包膜，肿块质地韧，多为实性；免疫组化指标细胞角蛋白（AE1／AE3）、抗胰蛋白酶（α-AT）及抗糜蛋白酶（α-ACT）均呈阳性，人嗜铬蛋白A（CgA）为阴性。pTNM分期Ⅱ期2例，Ⅲ期1例，Ⅳ期3例。术后病人平均随访60个月，平均生存期为（32±8）个月。结论：胰腺腺泡细胞癌具有特殊的临床表现和特钲性病理形态学改变．免疫组化以AE1／AE3、α-AT及α-ACT等腺泡细胞标记物表达为主。

Analysis of clinical and histopathological characteristics of pancreatic acinar cell carcinoma

Objective To investigate and summarize the clinical and histopathologieal features of pancreatic acinar cell carcinoma. Methods The clinical data of the patients with pancreatic aeinar cell carcinoma admitted in Peking Union Medical College Hospital in the last 10 years were retrospectively reviewed. Results Six cases of pancreatic acinar cell carcinoma undergoing operation were collected, their main clinical manifestations included abdominal or back pain, nausea or vomiting, and weight loss. The tumor located in the head of the pancreas in 2 cases, in the uncinate process in 1 case, and in the body or tail in 3 cases. Macroscopically, pancreatic acinar cell carcinoma were generally large （the average diameter was 7.00 cm×5.92 cm×5.00 cm）, well-circumscribed solid lesions; immunohistochemieally, the expression of AE1/AE3, α-AT and α-ACT was positive, that of CgA was negative. According to the pTNM staging, there were 2 cases in stage Ⅱ, 1 in stage Ⅲ, and 3 in stage Ⅳ. The average period of postoperative follow-up was 60 months, and the mean survival time was （32±8） months. Conclusions Pancreatic acinar cell carcinoma presents unique clinical and histopathological manifestations. Immnobistochemical staining showes positive expression in AE1/AE3, α-AT and α-ACT which are the markers of acinar cells.