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目的探讨胰腺实性-假乳头状肿瘤(SPTP)的临床病理学特点、诊断与鉴别诊断、生物学行为,治疗及其预后。方法回顾性分析53例SPTP临床病理特征、治疗及免疫组化资料。结果 53例SPTP中,女性44例,男性9例,年龄12～55岁,平均年龄30岁。肿瘤位于胰头20例,胰体尾部33例,肿瘤大小平均为7.2 cm×5.8 cm×4.4 cm大小,切面囊实性。镜检:肿瘤细胞围绕纤维血管轴心形成特征性假乳头结构,细胞大小较一致,核圆或卵圆,异型不明显,核分裂象罕见。免疫组化:CD56(41例)、vimentin(25例)、CD10(37例)、α-AT(25例)、CK-Pan(9例)、Syn(23例)、CgA(3例)均(+),gastrin和insulin均(-),Ki-67阳性率1例为40%,其余均<5%。随访45例,中位随访时间61个月,1例术后14个月死于肿瘤复发与转移,其余均无瘤生存。结论 SPTP是一种少见的胰腺外分泌肿瘤,好发于年轻女性,手术效果较好。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis, biological behavior, treatment and prognosis of pancreatic solid pseudopapillary tumor (SPTP). Methods A retrospective analysis of 53 cases of SPTP clinical and pathological features, treatment and immunohistochemical data. Results In 53 cases of SPTP, 44 were female and 9 were male, aged from 12 to 55 years with a mean age of 30 years. Tumors were located in the head of the pancreas in 20 cases, 33 cases of pancreatic body tail, the average tumor size of 7.2 cm × 5.8 cm × 4.4 cm size, section of cystic solidity. Microscopic examination: tumor cells around the axis of the fibrovascular features of the formation of characteristic pseudopapillary structure, cell size more consistent, nuclear or oval, shaped is not obvious, mitotic figures rare. Immunohistochemistry: CD56 in 41 cases, vimentin in 25 cases, CD10 in 37 cases, α-AT in 25 cases, CK-Pan in 9 cases, Syn in 23 cases, CgA in 3 cases (+), gastrin and insulin (-), the positive rate of Ki-67 was 40% in one case and the others were less than 5%. Follow-up 45 cases, the median follow-up time of 61 months, 1 case died of tumor recurrence and metastasis 14 months after surgery, the rest were tumor-free survival. Conclusion SPTP is a rare pancreatic exocrine tumor, which occurs in young women with good surgical results.