胰腺实性假乳头状肿瘤10年病例的临床分析
Ten-year case review of solid-pseudopapillary neoplasm of pancreas

摘要：目的 总结分析胰腺实性假乳头状肿瘤(SPN)的诊断及治疗方法，以期为临床早期诊断提供参考。方法 收集自2004年2月至2014年9月收治于西安交通大学第一附属医院的62例经病理检查证实的SPN患者的临床资料，对SPN的临床特征、诊断、治疗方法进行回顾性分析与总结。结果 62例患者中女性55例(88.71%)，男性7例(11.29%)，平均年龄(31.58±12.67)岁，临床表现无特异性，多为体检时发现，肿瘤好发于胰体尾部，平均最大径(7.81±3.54)cm，术前血常规、肝肾功均未见明显异常，影像学提示胰腺占位，均行手术治疗。术后恢复良好，无死亡病例，均无并发症发生，术后病理诊断均为胰腺实性假乳头状肿瘤，均未见淋巴结转移。至末次随访时62例患者均存活，2例(3.2%)复发。结论 SPN是好发于中青年女性的低度恶性肿瘤，临床表现缺乏特异性，影像学具有重要诊断价值，手术治疗效果好。
ABSTRACT: Objective To summarize the methods of diagnosing and treating solid-pseudopapillary neoplasm of pancreas SPN so as to provide reference for its early clinical diagnosis. Methods We collected the clinical data of 62 patients with pathologically confirmed diagnosis of SPN treated in the First Affiliated Hospital of Xi？？an Jiaotong University between Feb. 2004 and Sep. 2014. Then we retroactively analyzed and summarized the clinical characteristics, diagnosis and treatment of the disease. Results Among the 62 patients, 55 were female and 7 were male; the mean age was (31.58±12.67) years old. The clinical features showed no specificity and the tumor was mostly detected upon physical check-up. The tumor was seen to be located mostly in the body and tail of the pancreas, and the average maximum diameter was (7.81±3.54)cm. We did not find obvious abnormality in routine pre-operative blood test results or liver and kidney functions. The imageological examination indicated tumor occupation in the pancreas. All the patients underwent surgical resection with no complications or death and had a good recovery after operation. Pathological diagnosis after operation was SPN without metastasis in lymph modes. Until the last time we followed up all the patients, we found relapse in two patients (3.2%). Conclusion SPN is a tumor that tends to affect young and middle-aged females. The malignancy grade of SPN is low, and patients with this disease show no specificity in clinical manifestation. The imageological examination is of vital importance in diagnosing SPN and surgical resection is an effective way to treat SPN