中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (05): 372-374.

• 论著 • 上一篇    下一篇

无症状性胰腺囊性肿瘤的临床及病理特征分析

戴梦华1，徐    涛2，张太平1，廖    泉1，丛    林1，郭俊超1，胡    亚1，曹    越1，赵玉沛1，蔡力行1   

  1. 1中国医学科学院 北京协和医院基本外科, 北京，100730; 2中国医学科学院基础医学院, 北京100730
  • 出版日期:2010-05-01 发布日期:2010-05-06

  • Online:2010-05-01 Published:2010-05-06

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摘要：

目的    探讨及分析无症状性胰腺囊性肿瘤的临床及病理特征。方法    回顾性分析北京协和医院1984年1月至2008年6月126例经手术治疗的胰腺囊性肿瘤的病例资料。结果    126例胰腺囊性肿瘤的病人中，60例无症状，其中56例为良性，28例为浆液性囊腺瘤，25例为黏液性囊腺瘤，3例为导管内乳头状黏液性肿瘤；4例为恶性，3例为黏液性囊腺癌，1例为侵袭性导管内黏液性肿瘤。 采用单因素和多因素变量分析结果显示病人的性别，肿瘤大小和影像学特征性表现（包括实性成分和主胰管扩展）在胰腺良、恶性囊性肿瘤之间差异有统计学意义，男性在恶性肿瘤中显著多于女性（P=0.01）； 影像学特征性表现是常常是判断肿瘤恶性可能的独立因素。对于直径<3cm的肿瘤，无症状的胰腺囊性肿瘤更多见于良性肿瘤。结论    在无症状胰腺囊性肿瘤中，恶性肿瘤发病率比较低，尤其对于肿瘤直径<3cm的无症状囊性肿瘤，如果影像学检查显示囊肿内无实性成分或乳头状突起，胰管不扩张者，可采用保守观察的方法，定期随访。

关键词: 囊性肿瘤, 胰腺病理特征, 恶性肿瘤

Abstract:

Analysis of clinical and pathological features of asymptomatic cystic neoplasms of pancreas        DAI Meng-hua*, XU Tao, ZHANG Tai-ping et al. *Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences , Beijing 100730, China
Corresponding author: ZHAO Yu-pei, E-mail: zhao8028@263.net
Abstract    Objective    To analyze and study clinical and pathological features of incidental cystic neoplasms of pancreas. Methods    The clinical data of 126 cases of pancreatic resection performed for cystic neoplasms between January 1984 and June 2008 at Peking Union Medical College Hospital were evaluated retrospectively. Results    Among 126 cases of cystic neoplasms of pancreas, 60 cases were asymptomatic including 56 cases of benign and 4 cases of malignant. The benign cases included 28 cases of serous cystic neoplasms, 25 cases of mucinous cystic neoplasms and 3 cases of intraductal papillary mucinous neoplasms. The malignant cases inclued 3 cases of mucinous cystic adenocarcinoma and 1 case of invasive intraductal papillary mucinous neoplasm. Univariate and multivariate analysis showed that gender, tumor size and radiological features(solid component and main duct dilation) were significant different between benign and malignant cystic neoplasm of pancreas. Gender was a predictor of malignant pathology, with male cases having a higher incidence of malignancy (3/11, 27.3%) compared with female cases (1/44, 2.27%; P=0.001). The presence of radiographic features (solid component and main pancreatic duct dilation) was associated with malignancy of cystic neoplasms. Tumor size less than 3cm in diameter was more common in benign, asymptomatic cystic neoplasms of pancreas. Conclusion    Among asymptomatic cystic neoplasms of pancreas, the incidence of malignant cases is  lower. The study suggests that if tumor size in asymptomatic cases is less than 3cm in diameter without malignant radiographic features (solid component and main pancreatic duct dilation) observation and regular folllow-up can be selected.  

Key words: cystic neoplasm, pathologic feature of pancreas, malignancy