中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2012年
9期
73-77
,共5页
王志意%崔现平%耿文茂%秦成坤
王誌意%崔現平%耿文茂%秦成坤
왕지의%최현평%경문무%진성곤
胰腺肿瘤%诊断%治疗%实性假乳头状瘤
胰腺腫瘤%診斷%治療%實性假乳頭狀瘤
이선종류%진단%치료%실성가유두상류
Pancreatic neoplasm%Diagnosis%Treatment%Solid-pseudopapillary tumor
[目的]总结胰腺实性假乳头状瘤(SPTP)的临床特点及外科治疗经验,提高SPTP的术前诊断及治疗水平.[方法]回顾性分析2000年6月至2010年12月于山东大学附属省立医院接受手术治疗的50例SPTP患者的临床资料.50例患者中,男4例,女46例,男女比例1∶11.5,平均年龄23.7岁(11 ～48岁).17例有上腹部不适、疼痛或腹泻症状,30例因腹部肿块就诊,3例以梗阻性黄疸为首发症状.所有患者术前实验室检查均为阴性,术前诊断主要依靠腹部超声、CT等影像学检查.所有患者均手术治疗,术后均未行化疗和放疗.[结果]术后病理5例为低度恶性SPTP,1例为恶性SPTP.肿瘤位于胰头部26例,位于胰颈部4例,位于胰体部2例,位于胰体尾部10例,位于胰尾部8例,肿瘤平均直径为7.9 cm(3～ 19 cm).术后8例发生胰瘘,2例出现胃瘫,均对症处理后好转.所有患者术后恢复良好,平均随访39个月(2～87个月),均未出现肿瘤复发及转移迹象.[结论]SPTP是一种少见的低度恶性或交界性肿瘤,主要见于20～30岁的年轻女性,大多数情况手术切除均能治愈,预后良好.
[目的]總結胰腺實性假乳頭狀瘤(SPTP)的臨床特點及外科治療經驗,提高SPTP的術前診斷及治療水平.[方法]迴顧性分析2000年6月至2010年12月于山東大學附屬省立醫院接受手術治療的50例SPTP患者的臨床資料.50例患者中,男4例,女46例,男女比例1∶11.5,平均年齡23.7歲(11 ～48歲).17例有上腹部不適、疼痛或腹瀉癥狀,30例因腹部腫塊就診,3例以梗阻性黃疸為首髮癥狀.所有患者術前實驗室檢查均為陰性,術前診斷主要依靠腹部超聲、CT等影像學檢查.所有患者均手術治療,術後均未行化療和放療.[結果]術後病理5例為低度噁性SPTP,1例為噁性SPTP.腫瘤位于胰頭部26例,位于胰頸部4例,位于胰體部2例,位于胰體尾部10例,位于胰尾部8例,腫瘤平均直徑為7.9 cm(3～ 19 cm).術後8例髮生胰瘺,2例齣現胃癱,均對癥處理後好轉.所有患者術後恢複良好,平均隨訪39箇月(2～87箇月),均未齣現腫瘤複髮及轉移跡象.[結論]SPTP是一種少見的低度噁性或交界性腫瘤,主要見于20～30歲的年輕女性,大多數情況手術切除均能治愈,預後良好.
[목적]총결이선실성가유두상류(SPTP)적림상특점급외과치료경험,제고SPTP적술전진단급치료수평.[방법]회고성분석2000년6월지2010년12월우산동대학부속성립의원접수수술치료적50례SPTP환자적림상자료.50례환자중,남4례,녀46례,남녀비례1∶11.5,평균년령23.7세(11 ～48세).17례유상복부불괄、동통혹복사증상,30례인복부종괴취진,3례이경조성황달위수발증상.소유환자술전실험실검사균위음성,술전진단주요의고복부초성、CT등영상학검사.소유환자균수술치료,술후균미행화료화방료.[결과]술후병리5례위저도악성SPTP,1례위악성SPTP.종류위우이두부26례,위우이경부4례,위우이체부2례,위우이체미부10례,위우이미부8례,종류평균직경위7.9 cm(3～ 19 cm).술후8례발생이루,2례출현위탄,균대증처리후호전.소유환자술후회복량호,평균수방39개월(2～87개월),균미출현종류복발급전이적상.[결론]SPTP시일충소견적저도악성혹교계성종류,주요견우20～30세적년경녀성,대다수정황수술절제균능치유,예후량호.
[Objective]To sum up the clinical characteristics and surgical treatment experience and improve the preoperative diagnosis and treatment level of solid-pseudopapillary tumor of pancreas(SPTP).[Methods] A series of fifty patients with SPTP managed in Provincial Hospital Affiliated to Shandong University between June 2000 and December 2010 were retrospectively reviewed and analyzed.[Results] Among 50 patients,4 were men and 46 were women.The male to female ratio was 1 ∶ 11.5.The mean age of the 50 patients in this research was 23.7 years (ranging from 11 to 48 years).Clinical presentation included abdominal discomfort,pain or diarrhea in 17 patients and a palpable abdominal mass in another 30 patients.Obstructive jaundice was the first symptom in three patients.Preoperative laboratory tests of all patients were negative.Preoperative diagnosis of SPTP mainly depends on Bultrasound and CT scan.All patients were treated surgically.None of the patients were received postoperative radiation and chemotherapy.The location of the tumors were the head ( 26 cases),the neck (4 eases),the body ( 2cases ),the body and tail( 10 cases),and the tail( 8 cases ).The mean diameter of the tumors was 7.9 cm( range 3-19cm).Postoperative complications occurred in 10 cases,including pancreatic fistula in 8 cases,gastroparesis in 2cases,whom all recovered from symptomatic treatment.The mean follow up was 39 months(range 2 to 87 months),and no evidence of recurrence and metastasis was found during the follow up period.[Conclusions]SPTP is a rare borderline tumor or neoplasm with a low potential,usually affecting young women in the second or third decade of life.Surgical resection is generally curative and the prognosis is excellent.
