胰腺实性假乳头状肿瘤的诊断及外科治疗分析  

Diagnosis and surgical treatment of solid pseudopapillary neoplasm of pancreas

作　　者：周泉波[1] 郭宁[1] 林笑丰[2] 林青[1] 陈汝福[1] 王捷[1] 陈积圣[1] 

机构地区：[1]中山大学孙逸仙纪念医院肝胆外科,广州510120 [2]中山大学孙逸仙纪念医院放射科,广州510120

出　　处：《中华肝胆外科杂志》2012年第7期499-502,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨胰腺实性假乳头状肿瘤（SPN）的诊治方法，以期为临床提供参考、避免误诊，并采取正确治疗SPN的措施。方法收集2001年2月至2009年12月收治的24例手术治疗SPN患者的临床资料，回顾性分析其临床表现、实验室检查、影像学、病理学及手术治疗特征。结果本组24例中，23例为女性，平均发病年龄31岁。SPN最常见的临床表现是腹痛和腹部肿块。影像学检查显示胰腺的实性或囊-实性占位病变，大部分肿瘤位于胰腺头部和尾部。24例均行肿瘤切除，22例获得根治性切除，术后获得长期生存，无复发征象；1例R1切除患者死于术后42个月，另1例R1切除患者术后复发，再次手术后获得长期生存。结论SPN是一种低度恶性的肿瘤。SPN的正确诊断需要综合分析其临床特征、影像学检查及病理组织学特点。根治性切除能够阻止术后复发，减瘤切除手术对提高患者生存是有益的。Objective To review our experience in the diagnosis and surgical treatment of solid pseudopapillary neoplasm （SPN） of the pancreas which can be used as a reference for other doctors to avoid misdiagnosis and to provide a better treatment. Method The clinical, laboratory, radiological, pathological and operative data of 24 patients with SPN of the pancreas operated between February 2001 to December 2009 were collected and retrospectively analyzed. Results 23 of 24 patients were female and the mean age was 31 years. The most common clinical presentations were vague abdominal pain and abdominal mass. In most cases, abdominal imaging showed a solid or a solid-cystic mass in the tail or head of pancreas. All patients received surgery. 20 of 22 patients who received curative re- section were alive with no evidence of tumour recurrence. One patient who had a R1 resection died 42 months after surgery. The remaining patient was alive after a second operation. Conclusions SPN of the pancreas is a tumour with low malignancy. A correct diagnosis of SPN of the pancreas is made on its clinical, radiological and histopathological characteristics. Radical surgical resection is the treat- ment of choice. For patients with an advanced disease, palliative resection is beneficial.

关 键 词：胰腺肿瘤 实性假乳头状肿瘤 诊断 治疗 

分 类 号：R735.9[医药卫生—肿瘤]