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目的探讨胰腺实性假乳头状瘤(SPT)的诊断、治疗和预后。方法回顾性分析中国协和医科大学肿瘤医院腹部外科1999年1月至2006年11月收治的29例实性假乳头状瘤的临床表现、影像学特征、病理结果、治疗和预后。结果28例获得手术切除,术式包括Whipple术、胰体尾联合脾切除术、胰腺区段切除和肿瘤局部切除,术后出现胰漏4例,消化道出血1例,经治疗后恢复出院,1例未能切除者行化疗和介入治疗。术后随访2个月至7年,除未能切除的1例术后14个月死亡外,其他均未出现复发和转移。结论SPT多见于年轻女性,临床表现无特异性。CT是最准确的影像检查方法,结合临床特点可以在术前作出准确诊断。SPT的恶性程度较低,以手术切除为主,完整切除后预后良好。
Objective To investigate the diagnosis, treatment and prognosis of solid pseudopapillary pancreatic tumor (SPT). Methods The clinical manifestations, imaging features, pathological findings, treatment and prognosis of 29 patients with solid pseudopapillary neoplasia admitted to the Department of Abdominal Surgery, Peking Union Medical College Cancer Hospital from January 1999 to November 2006 were retrospectively analyzed. Results Eighty-eight patients underwent surgical resection. Whipple operation, pancreatic body tail combined with splenectomy, pancreatectomy and tumor resection were performed. There were 4 cases of pancreatic leakage and 1 case of gastrointestinal bleeding after operation. The patients were discharged after treatment, One patient failed to undergo chemotherapy and interventional therapy. All cases were followed up for 2 months to 7 years. No recurrence or metastasis occurred in 1 case except 14 months after operation. Conclusion SPT more common in young women, clinical manifestations of non-specific. CT is the most accurate imaging method, combined with clinical features can be accurately diagnosed before surgery. The degree of malignancy of SPT is lower, which is mainly surgically removed. The prognosis is good after complete resection.