胰腺实性假乳头状瘤临床特征与诊治:附9例报告并文献复习
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董明E-mail:mingdong@mail.cmu.edu.cn

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Diagnosis and treatment of solid pseudopapillary tumor of the pancreas:a report of nine cases and a review of literature
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    摘要:

    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。

    Abstract:

    Objective:To investigate clinical features and clinical experience of diagnosis and treatment of solid-pseudopapillary tumor of the pancreas (SPTP).
    Methods:The clinical records of  757 cases of SPTP were analyzed retrospectively, which included 748 cases concerning SPTP published in Chinese medical journals and 9 cases of SPTP admitted to our hospital.
    Results:Among the patients, 66 were males, 691 were females, and the mean age was 26.6 years. Major clinical manifestations were abdominal pain or discomfort (45.3%) and palpable abdominal masses (35.5%),but some cases (22.0%) were completely asymptomatic and the lesions were detected by routine examinations. In 95.9% of cases,  B ultrasonic examinations could detect the tumors,but the accuracy for judging the location of tumors by CT(87.5%) and MRI(90%) was better than that by B ultrasonic exam (71.2%). The tumors were often located in the head (39.1%) or the body and tail (54.1%) of the pancreas. The main treatment for SPTP was surgical procedure including enucleation (34.1%), pancreatoduodenectomy (23.7%) and distal pancreatectomy with splenectomy (22.5%).It was found that 60.3% of the tumors were solid and cystic, had complete capsule, and had a mean diameter of 8.0 cm.Among the 458 cases that were followed up, 450 cases were alive, including 3 cases with recurrences, 3 cases treated with tumor reductive surgery and 1 case with hepatic metastases after surgery. Of the 450 cases 8 died.
    Conclusions:SPTP occurs predominantly in young females. Surgical procedure is the main effective treatment, and the prognosis is good, even for the cases with metastases or recurrences, the aggressive surgical therapy is good.

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姚殿波|董明|董齐|李新|周建平|田雨霖.胰腺实性假乳头状瘤临床特征与诊治:附9例报告并文献复习[J].中国普通外科杂志,2010,19(3):297-300.
DOI:10.7659/j. issn.1005-6947.2010.03.017

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  • 收稿日期:2009-09-29
  • 最后修改日期:2010-02-18
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  • 在线发布日期: 2010-03-15