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目的探讨胰腺实性假乳头状瘤的临床特征与诊治经验。方法回顾性分析9例及文献已报道的748例胰腺实性假乳头状瘤患者的临床资料。结果男66例,女691例;平均年龄26.6岁。45.3%有上腹部疼痛或腹胀不适,35.5%有上腹肿块,22.0%因体检发现腹腔肿物就诊。超声检查95.9%可探查到肿物,CT和MRI检查对肿瘤位置判断的准确率分别为87.5%和90%,优于超声检查(71.2%)。39.1%肿瘤位于胰头部,54.1%位于胰体尾部。治疗术式多为肿瘤摘除术(34.1%),胰十二指肠切除术(23.7%)和胰体尾脾切除术(22.5%)。60.3%肿瘤为囊实性,包膜完整,平均最大直径为8.0 cm。随访458例,450例生存良好,包括3例肿瘤复发,3例行减瘤手术和1例术后发生肝转移的患者;随访中死亡8例。结论胰腺实性假乳头状瘤多发于青年女性,手术为其主要治疗方式,预后良好,对转移或复发病例积极手术治疗仍可获得较好疗效。
Objective To investigate the clinical features and diagnosis and treatment of solid pseudopapillary tumors of the pancreas. Methods The clinical data of 9 cases and 748 solid pseudopapillary tumors of the pancreas reported in the literature were retrospectively analyzed. Results There were 66 males and 691 females with a mean age of 26.6 years. 45.3% had abdominal pain or bloating discomfort, 35.5% had abdominal mass, and 22.0% found abdominal mass due to physical examination. Ultrasound examination 95.9% of the tumor can be detected, CT and MRI examination of tumor location accuracy of 87.5% and 90% respectively, better than ultrasound (71.2%). 39.1% of the tumors were located in the head of pancreas and 54.1% were located in the tail of pancreas. Most of the therapies were tumor resection (34.1%), pancreatoduodenectomy (23.7%) and pancreas tail splenectomy (22.5%). 60.3% of the tumor was cystic solid, complete capsule, the average maximum diameter of 8.0 cm. A total of 458 patients were followed up, and 450 survived well, including 3 patients with tumor recurrence, 3 patients underwent sarcoma surgery and 1 patient with liver metastasis. Eight patients died during follow-up. Conclusions Solid pseudopapillary tumors of the pancreas are frequently found in young women. Surgery is the main treatment and the prognosis is good. Positive surgical treatment of metastatic or recurrent cases can still achieve good results.