胰腺黏液性囊性肿瘤的临床病理特点及良恶性影响因素分析  

Clinicopathological features of pancreatic mucinous cystic neoplasm and influencing factors for its malignancy

作　　者：侯丽艳[1] 贾如江[1] 王秀超[2] 兰春根 尹清臣[1] 

机构地区：[1]邯郸市中心医院,河北邯郸056102 [2]天津医科大学附属肿瘤医院,天津300060

出　　处：《临床肝胆病杂志》2017年第8期1514-1517,共4页Journal of Clinical Hepatology

摘　　要：目的探讨胰腺黏液性囊性肿瘤(MCN)的临床病理特点并分析其良恶性的影响因素。方法回顾性分析2013年1月-2015年12月天津市肿瘤医院和邯郸市中心医院收治的经术后病理证实的43例胰腺MCN患者的临床资料,根据病理诊断结果分为良性组(包括黏液性囊腺瘤及胰腺MCN伴低/中级别异型增生)和恶性组(包括MCN伴高级别异型增生及MCN伴浸润癌)。总结2组患者的临床病理特点和影像学特征,分析胰腺MCN发生恶变的相关危险因素。计量资料组间比较采用独立样本t检验,计数资料组间比较采用χ~2检验,多因素分析采用logistic回归分析。结果 43例患者中男14例,女29例,年龄22~81岁,中位年龄58.53岁。有临床症状的患者30例(69.8%)。肿瘤最大直径4.8 cm(1.2~16 cm)。肿瘤位于胰头部18例(41.9%),胰颈3例(7.0%),体尾部20例(46.5%),2例(4.6%)为多发。2组患者在年龄、肿瘤性质、肿瘤部位、质地、肿瘤标志物、囊壁不均质强化、伴有实性成分不均质强化、囊壁厚度>0.2 cm上差异均有统计学意义(P值均<0.05)。多因素logistic回归分析显示年龄、肿瘤标志物升高是恶性胰腺MCN的独立预测因素(P值均<0.05)。结论年龄、肿瘤性质、肿瘤部位、质地、肿瘤标志物升高、囊壁不均质强化、伴有实性成分不均质强化、囊壁厚度>0.2 cm为恶性胰腺MCN的重要特点,其中年龄、肿瘤标志物升高为恶性胰腺MCN的独立危险因素。Objective To investigate the clinicopathological features of pancreatic mucinous cystic neoplasm（ MCN） and influencing factors for benign and malignant MCN. Methods A retrospective analysis was performed for the clinical data of 43 patients with pathologically confirmed pancreatic MCN who were treated from January 2013 to December 2015,and according to the results of pathological diagnosis,the patients were divided into benign group（ mucinous cystadenoma and pancreatic MCN with low/middle-grade dysplasia） and malignant group（ MCN with high-grade dysplasia and MCN with invasive carcinoma）. The clinicopathological features and radiological features were summarized,and the risk factors for malignant transformation of pancreatic MCN were analyzed. The independent samples t-test was used for comparison of continuous data between groups,the chi-square test was used for comparison of categorical data between groups,and a multivariate logistic regression analysis was used to identify risk factors. Results There were 14 male and 29 female patients aged 22-81 years（ median 58. 53 years）. Of all patients,30（ 69. 8%） had clinical symptoms. The maximum tumor diameter was 4. 8 cm（ range 1. 2-16cm）. Of all patients,18（ 41. 9%） had MCN in the head of the pancreas,3（ 7. 0%） had MCN in the neck of the pancreas,20（ 46. 5%）had MCN in the body and tail of the pancreas,and 2（ 4. 6%） had multiple MCNs. There were significant differences between the two groups in age,tumor nature,tumor location,texture,tumor markers,heterogeneous enhancement of the cyst wall,heterogeneous enhancement of solid components,and cyst wall thickness 0. 2 cm（ all P 0. 05）. The multivariate logistic regression analysis showed that age and increased tumor markers were independent predictive factors for malignant pancreatic MCN（ both P 0. 05）. Conclusion Age,tumor nature,tumor location,texture,increased tumor markers,heterogeneous enhancement of the cyst wall,heterogeneous enhancement of solid components,and cyst wa

关 键 词：胰腺疾病 肿瘤 囊性 黏液性和浆液性 病理状态 体征和症状 危险因素 

分 类 号：R735.9[医药卫生—肿瘤]