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目的探讨胰腺实性假乳头状瘤临床病理和免疫组化特征、组织起源及生物学行为。方法对20例胰腺实性假乳头状瘤手术标本进行HE和免疫组化SP法染色检查。结果 20例患者中女性18例,男性2例,年龄13-48岁,平均25．3岁。多以腹块、腹痛为首发症状。术后17例获得随访,随访时间9-120个月。其中14例生存至今,3例患者死亡。肿瘤组织学特征:有包膜,囊实性混合,镜下特征性结构为肿瘤细胞围绕纤维血管复层排列形成假乳头状突起。免疫组化α-1抗胰蛋白酶17例(85％)和波形蛋白14例(70％)弥漫阳性,突触素阳性10例(50％),嗜铬粒素A灶状弱阳性5例(25％),细胞角蛋白阳性2例(10％),胰岛素阳性2例(10％)和胰高血糖素阳性1例 (5％),S-100蛋白阳性1例(5％),孕激素受体(PR)弥漫强阳性14例(70％),雌激素受体(ER)阳性 1例(5％),pS2蛋白阳性6例(30％),癌胚抗原及胃泌素全部阴性。结论胰腺实性假乳头状瘤多发生在年轻女性,肿瘤细胞多为外分泌细胞及内分泌细胞分化,与性激素受体关系密切,是一种低度恶性肿瘤。
Objective To investigate the clinicopathological and immunohistochemical features, histological origin and biological behavior of solid pseudopapillary tumors of the pancreas. Methods 20 cases of solid pseudopapillary tumor of pancreas were stained with HE and immunohistochemistry. Results Among the 20 patients, 18 were female and 2 were male, ranging in age from 13 to 48 years with an average of 25.3 years. More with abdominal mass, abdominal pain as the first symptom. Seventeen patients were followed up for 9-120 months. Of these, 14 have survived so far and three have died. Tumor histological features: a capsule, cystic solid mixed, microscopic features of the tumor cells arranged around the fibrovascular stratified pseudopapillary protrusion. Seventeen (85%) cases of immunohistochemical α-1 antitrypsin and 14 cases (70%) of vimentin were diffusely positive, 10 (50%) were positive for synaptophysin and 5 were weakly positive for chromogranin A 25%), cytokeratin 2 (10%), insulin 2 (10%), glucagon 1 (5%), S-100 protein 1 Receptor (PR) diffuse strongly positive in 14 cases (70%), estrogen receptor (ER) in 1 case (5%), pS2 protein positive in 6 cases (30%), carcinoembryonic antigen and gastrin all negative. Conclusions Solid pseudopapillary tumors of the pancreas occur mostly in young women. Most of the tumor cells are exocrine and endocrine cells, which are closely related to the sex hormone receptors. They are low grade malignant tumors.