【摘要】 目的探讨胰腺实性-假乳头瘤(SPN)的临床特点、病理学特征、鉴别诊断及预后。方法回顾性分析本院2014年1月-2018年2月14例SPN患者的临床病理学资料并复习相关文献。结果 14例患者中女11例,男3例,发病年龄13～77岁,平均33. 1岁。主要由体检发现病变或出现上腹疼痛后就诊。影像学检查均为胰腺占位性病变。肿瘤最大径0. 6～22 cm。组织学肿瘤主要由实性区和假乳头区构成,局灶出现微囊状结构。免疫组化示所有病例Vimentin阳性,CgA、Glucagon、Gastrin、Insulin均阴性,部分病例β-catenin(13例)、CD10(10例)、CD56(9例)、Syn(8例)、AA-T(11例)、PR(8例)、CyclinD1(9例)、CA19-9(3例)、CK-P(9例)、CEA(1例)、P53(1例)阳性,Ki-67阳性率(14例)≤10%。结论诊断SPN需结合临床资料、影像检查、组织学形态及免疫组化综合分析,微囊状结构对诊断SPN有一定意义。更多还原

【Abstract】 Objective To investigate the clinical features,pathological features,differential diagnosis,and prognosis of solid pseudopapillary neoplasm( SPN) of the pancreas. Methods A retrospective analysis was performed for the clinical data of 14 patients with SPN who were treated in our hospital from January 2014 to February 2018,and related articles were reviewed. Results There were 11 female and 3 male patients with an age of onset of 13-77 years( mean 33. 1 years). Most of them attended the hospital due to lesions found by physical examination or the presence of upper abdominal pain. Radiological examination revealed space-occupying lesion in the pancreas. The maximum diameter of the tumor ranged from 0. 6 cm to 22 cm. Histological examination showed that most tumors were composed of solid areas and pseudopapillary areas,with a microcystic structure in local lesion. Immunohistochemistry showed positive Vimentin and negative CgA,Glucagon,Gastrin,and Insulin in all patients. Some patients were positive for β-catenin( 13/14),CD10( 10/14),CD56( 9/14),Syn( 8/14),AA-T( 11/14),PR( 8/14),CyclinD1( 9/14),CA19-9( 3/14),CK-pan( 9/14),CEA( 1/14),and P53( 1/14). Ki-67 index was ≤10% in all 14 patients. Conclusion SPN of the pancreas should be diagnosed with reference to clinical data,imaging examination,histological features,and immunohistochemistry. The microcystic structure has a certain value in the diagnosis of SPN.更多还原