胰腺神经鞘瘤临床诊治分析  

Clinical analysis of diagnosis and treatment of pancreatic schwannoma

作　　者：李宁[1] 翁杰锋[1] 张强[1] 林帆[1] 朱光辉[1] 温敏杰[1] 古维立[1] 

机构地区：[1]广州医科大学附属广州市第一人民医院肝胆外科,广州消化疾病中心,广州510180

出　　处：《广州医药》2016年第4期21-24,共4页Guangzhou Medical Journal

基　　金：国家自然科学基金项目(81400679);广东省基础与应用基础研究专项资金项目(2014A030310067);广东省医学科研基金项目(B2014340)

摘　　要：目的探讨胰腺神经鞘瘤的临床特点和诊治方法。方法总结并回顾性分析我院肝胆外科收治的胰腺神经鞘瘤患者1例及文献报道的71例患者临床资料。结果共计72例胰腺神经鞘瘤患者纳入总结和分析。患者平均年龄54岁（范围17-89岁）,其中女性40例（56%）。临床表现包括上腹痛、体重减轻,或体检偶然发现胰腺肿物。肿瘤平均大小6.1 cm（1-20 cm）。肿瘤位于胰头部29例（40%）、胰体/尾部32例（44%）,沟突部6例（8%）。肿瘤表现为实性肿物27例（38%）、囊性28例（39%）、囊实性10例（14%）。2例通过术前超声内镜下穿刺活检病理确诊,其余均为手术后标本病理诊断证实。手术治疗行胰十二指肠切除术23例、局部剜除术16例、胰体尾切除术15例、胰腺中段切除1例。5例（7%）患者术后病理为恶性神经鞘瘤,恶性组肿瘤大小明显大于良性组[（13.8±6.2）cm vs（5.6±4.1）cm,P=0.0004）]。手术切除患者术后随访3-65月,均无肿瘤复发、转移及患者死亡。结论胰腺神经鞘瘤临床表现缺少特异性,术前诊断困难,肿瘤大小与良恶性具有明显相关性,手术治疗可取得良好效果。Objective To analyze clinical presentation,diagnosis,treatment options,and outcome of pancreatic schwannoma. Methods A retrospective study of clinical data of a case in our hospital and 71 cases reported in literature with pancreatic schwannoma. Results 72 cases were analysed.The mean age was 54 years （range 1 7-89 years）,with 56 % of pa-tients being female.Mean tumor size was 6.1 cm （range 1 -20 cm）.Tumor location was the head （29 cases）,body and tail （32 cases）,and uncinate process （6 cases）.27 cases exhibited solid tumors and 28 cases exhibited cystic tumors.Treatment includ-ed pancreaticoduodenectomy （23 cases）,distal pancreatectomy （1 5 cases）,enucleation （1 6 cases）.5 cases （7%）were ma-lignant schwannoma.Tumor size of malignant group was significant larger than benign group （1 3.8 ±6.2 cm vs 5.6 ±4.1 cm, P =0.0004）.There was no local recurrence metastasis,or death at the follow-up after operation （range 3-65 months）. Con-clusion The clinical manifestations of pancreatic schwannoma are lack of specificity and preoperative diagnosis remains difficul-ty.The tumor size was significantly related to classification of malignant or benign.Pancreatic schwannoma has satisfactory prog-nosis with surgical treatment.

关 键 词：胰腺神经鞘瘤 诊断 治疗 

分 类 号：R735.9[医药卫生—肿瘤]