儿童胰腺实性假乳头状瘤的临床分析  

Clinical analysis of solid pseudopapillary tumor of pancreas in children

作　　者：郭润东 杨书龙[1] 邰升[2] 陆文君[1] 李昭铸[1] Guo Rundong;Yang Shulong;Tai Sheng;Lu Wenjun;Li Zhaozhu(Department of Pediatric Surgery,the Second Affiliated Hospital,Harbin Medical University,Heilongjiang,Harbin 150006,China;Department of General Surgery,the Second Affiliated Hospital,Harbin Medical University,Heilongjiang,Harbin 150006,China)

机构地区：[1]哈尔滨医科大学附属第二医院小儿外科,黑龙江哈尔滨150006 [2]哈尔滨医科大学附属第二医院普通外科,黑龙江哈尔滨150006

出　　处：《发育医学电子杂志》2021年第4期254-258,共5页Journal of Developmental Medicine (Electronic Version)

基　　金：国家科技支撑计划(2006BAI05A06)。

摘　　要：目的探讨儿童胰腺实性假乳头状瘤(solid pseudopapillary tumor of pancreas,SPTP)的临床特点和诊治结局。方法回顾性分析哈尔滨医科大学附属第二医院从2010年9月至2021年3月收治的23例SPTP患儿的临床资料。分析该病的临床表现、影像学特点、肿瘤部位、病理、外科治疗和预后,并总结治疗经验。结果23例患儿的平均年龄为(13±3)岁,其中男性2例,女性21例。肿瘤位于胰头部9例,胰颈部1例,胰体尾部13例。肿瘤标志物异常14例,其中神经特异性烯醇化酶(neuron specific enolase,NSE)升高6例,糖类抗原(carbohydrate antigen,CA)125升高3例。所有病例均行手术治疗,行胰十二指肠切除手术7例,非胰十二指肠切除手术16例。23例患者中2例失访,1例复发再次手术切除肿瘤,术后出现胰瘘1例、胃瘫1例,术后因腹痛、肠梗阻表现二次入院行保守治疗者6例,随访患者中未发现死亡病例。结论SPTP是一种少见的低度恶性胰腺肿瘤,在女性患儿中更为高发,CT上的典型表现有助于该病的诊断,SPTP在病理学中的典型表现可以为确诊和后续治疗提供临床指导。肿瘤的完整切除可以使患者获得满意的疗效和术后生存率。Objective To explore the clinical characteristics,diagnosis and treatment of solid pseudopapillary tumor of pancreas(SPTP)in children.Methods The clinical data of 23 patients with SPTP in the Second Affiliated Hospital,Harbin Medical University from September 2010 to March 2021 were analyzed retrospectively.The clinical manifestations,imaging features,tumor location,pathology,surgical treatment and prognosis to summarize the treatment experience were analyzed.Results The average age of 23 patients was(13±3)years,including 2 males and 21 females.The tumors were located in the head of pancreas in 9 cases,the neck of pancreas in 1 case and the tail of pancreas in 13 cases.There were 14 cases with abnormal tumor markers,including 6 cases with elevated NSE and 3 cases with elevated CA125.All cases were treated by surgery.Pancreatoduodenectomy was performed in 7 cases and nonpancreatoduodenectomy in 16 cases.Among the 23 patients,2 cases were lost to follow-up,1 case recurred and underwent reoperation,1 case had pancreatic fistula and 1 case had gastroparesis,6 cases were hospitalized for abdominal pain and intestinal obstruction,and no death was found in the follow-up patients.Conclusions SPTP is a rare low-grade pancreatic tumor,which is more common in female children.The typical manifestations on CT are more helpful for the diagnosis of this disease.The typical manifestations of SPTP in pathology can provide clinical guidance for diagnosis and postoperative therapy.Complete tumor resection can make patients obtain satisfactory curative effect and postoperative survival rate.

关 键 词：胰腺实性假乳头状瘤 临床特点 手术方式 肿瘤免疫组织化学染色 儿童 

分 类 号：R735.9[医药卫生—肿瘤]