胰腺实性假乳头状瘤临床病理特征及预后的研究  

A study on the clinicopathological features and prognosis of solid-pseudopapillary tumor of the pancreas

作　　者：仲伟霞[1] 宋化著[2] 郭玲玲[3] 穆殿斌[4] 孙兰萍[1] 杨爱清[5] 战雪梅[6] 李俞慧[1] 李胜[7] 

机构地区：[1]山东省肿瘤医院病理科,济南250117 [2]菏泽市立医院病理科,274031 [3]苏州大学基础医学系病理教研室,215000 [4]山东省肿瘤医院病理科,250017 [5]山东省肿瘤医院病理科,271000 [6]临沂市人民医院病理科,276003 [7]山东省肿瘤医院肝胆外科,济南250117

出　　处：《中华普通外科杂志》2006年第4期244-247,共4页Chinese Journal of General Surgery

摘　　要：目的探讨胰腺实性假乳头状瘤临床病理和免疫组化特征、组织起源及生物学行为。方法对20例胰腺实性假乳头状瘤手术标本进行HE和免疫组化SP法染色检查。结果 20例患者中女性18例,男性2例,年龄13-48岁,平均25．3岁。多以腹块、腹痛为首发症状。术后17例获得随访,随访时间9-120个月。其中14例生存至今,3例患者死亡。肿瘤组织学特征:有包膜,囊实性混合,镜下特征性结构为肿瘤细胞围绕纤维血管复层排列形成假乳头状突起。免疫组化α-1抗胰蛋白酶17例(85％)和波形蛋白14例(70％)弥漫阳性,突触素阳性10例(50％),嗜铬粒素A灶状弱阳性5例(25％),细胞角蛋白阳性2例(10％),胰岛素阳性2例(10％)和胰高血糖素阳性1例 (5％),S-100蛋白阳性1例(5％),孕激素受体(PR)弥漫强阳性14例(70％),雌激素受体(ER)阳性 1例(5％),pS2蛋白阳性6例(30％),癌胚抗原及胃泌素全部阴性。结论胰腺实性假乳头状瘤多发生在年轻女性,肿瘤细胞多为外分泌细胞及内分泌细胞分化,与性激素受体关系密切,是一种低度恶性肿瘤。Objective To study the Clinicopathological and immunohistochemical features, histogenesis and biological behavior of solid pseudopapillary tumor of the pancreas （SPT）. Methods Routine HE and immunohistochemical （SP） methods were used in 20 cases of SPT. Results Them were 18 females and 2 males, age ranging from 13 to 48 years with mean age of 25, 3 years, Abdominal pain and palpable mass were among the main complains. Seventeen cases were followed-up from 9 to 120 monthes. Fourteen cases were alive. Tumors were encapsulated, mixed with solid and cystic tissues. Histological features were psudopapillary structure with a fibrovascular core. ImmunohistogicaUy,the tumors were positive for a-1-AT （ 17 cases ） , vimentin （ 14 cases ） , synaptophysin （ 10 cases ）, CgA （5 cases）,CK and insulin （2 cases）,glucagon and S-100 （1 case）,PR （14 cases） , ER （1 case）,pS2 （6 cases）, but all were negative for CEA and gastrin. Conclusion SPT is of low-graded malignancy and a distinct clinicopathologic entity in young female patients with both exocrine as well as endocrine differentiation. The tumor is closely related with sex hormone receptors.

关 键 词：胰腺肿瘤 病理学 临床 诊断 预后 性激素受体 

分 类 号：R735.9[医药卫生—肿瘤] R735.2[医药卫生—临床医学]