胰腺肉瘤样癌7例临床病理特征分析  

Clinicopathological features analysis of 7 cases with sarcomatoid carcinoma of the pancreas

作　　者：马艺杰 张慧芝 陆才德[1] 吴胜东 杨亦闻 胡杨科 王珂[1] Ma Yijie;Zhang Huizhi;Lu Caide;Wu Shengdong;Yang Yiwen;Hu Yangke;Wang Ke(Department of Hepatobiliary Pancreatic Surgery,The Affiliated Lihuili Hospital of Ningbo University,Ningbo 315048,China;Department of Pathology,Ningbo Clinical and Pathological Diagnosis Center,Ningbo 315048,China)

机构地区：[1]宁波大学附属李惠利医院肝胆外科,宁波315048 [2]宁波市临床病理诊断中心病理科,宁波315048

出　　处：《中华胰腺病杂志》2024年第5期338-343,共6页Chinese Journal of Pancreatology

基　　金：宁波市卫生健康青年技术骨干项目(2021QNJSGG-WK)。

摘　　要：目的探讨胰腺肉瘤样癌的临床病理特征及预后情况。方法回顾性分析2013年9月至2021年8月间宁波大学附属李惠利医院收治的7例胰腺肉瘤样癌的临床病理学资料,包括临床表现,实验室检查、影像学检查、病理组织学检查结果,手术方式及辅助治疗。采用免疫组织化学染色检测肿瘤组织标志物和上皮标志物的表达情况。结果7例胰腺肉瘤样癌中男性4例,女性3例,发病年龄51~88岁,平均69岁。术前均行CT检查,肿瘤位于胰头3例,胰体3例,胰尾部1例;4例为囊实性,3例为囊性。6例行根治性手术,1例行肿瘤部分切除活检术。镜下可见肿瘤主要由肉瘤样梭形细胞构成。免疫组织化学染色结果显示,瘤组织同时表达间叶标志物vimentin和上皮标志物CK7、CK19、CK(pan)及CAM5.2。患者总体预后较差,4例术后1年内死亡,其余3例健在无复发。结论胰腺肉瘤样癌的临床表现并不典型,但具有明显的病理学和免疫组织化学特征,预后较差。ObjectiveTo investigate the clinicopathologic features of sarcomatoid carcinoma of the pancreas.MethodsThe clinicopathological data of 7 cases with sarcomatoid carcinoma of the pancreas admitted in the Affiliated Lihuili Hospital of Ningbo University from September 2013 to August 2021 were retrospectively analyzed,including clinical manifestations,laboratory examination,imaging examination,pathological examination of tissue specimens,surgical methods and adjuvant treatments.Expressions of mesenchymal markers and epithelial markers in tumor tissues were determined by immunohistochemical staining.ResultsAmong the 7 cases of sarcomatoid carcinoma of the pancreas,there were 4 male and 3 female.The patient age ranged from 51 to 88 years old,and the mean age was 69 years old.All the patients underwent CT examimation before surgery.3 tumors were located in the head,3 in the body and 1 in the tail of the pancreas.CT examination also showed that 4 tumors were cystic solid and 3 were cystic.Six patients underwent radical surgery and one underwent partial resection for biopsy.Microscopically,the tumor was predominantly composed of sarcomatoid spindle-shaped cells.Immunohistochemical staining showed that the tumor expressed both mesenchymal markers vimentin and epithelial marker CK7,CK19,CK(pan)and CAM5.2.The overall prognosis of the patients was poor,4 cases died within 1 year after surgery,and the other 3 cases survived without recurrence.ConclusionsThe clinical manifestations of sarcomatoid carcinoma of the pancreas were not typical,but the pathological and immunohistochemical features are obvious and the prognosis is poor.

关 键 词：胰腺 病理诊断 肉瘤样癌 

分 类 号：R735.9[医药卫生—肿瘤]