CAJ | 학술논문

目的分析胰腺黏液性囊性肿瘤(MCN)的临床特征,提高对该疾病的认识.方法采用单中心回顾性研究,分析上海长海医院2000年1月至2013年12月期间手术治疗的125例MCN的临床资料,总结其临床特征.结果 125例MCN中,女性112例,男性13例,女:男为8.6:1,年龄25 ～ 77岁,平均(48 ±14)岁.38例(30.4％)患者无症状,87例(69.6％)有症状,以腹痛最常见(81.6％).肿瘤位于胰体尾部111例(88.8％),肿块平均直径(6.3±3.4)cm(1～ 20 cm).85例(68.0％)为多房结构.均不与胰管相通.术前影像学检查正确诊断率为27.2％.15例MCN在内镜超声引导下细针穿刺行细胞或组织病理学检查,其中14例(93.3％)囊液CEA＞800 μg/L.手术方式以胰体尾切除术为主,共102例(81.6％).组织病理学分级示MCN伴轻-中度异型增生110例(88.0％),伴重度异型增生2例(1.6％),伴浸润性癌13例(10.4％).非浸润性MCN术后2、5年生存率均为100％,浸润性MCN术后2、5年生存率均为54.0％.结论 MCN主要发生在中年女性,多位于胰腺体尾部,腹痛为主要症状,术前诊断较为困难,治疗以手术为主,非浸润性MCN可治愈.
목적 분석이선점액성낭성종류(MCN)적림상특정,제고대해질병적인식.방법 채용단중심회고성연구,분석상해장해의원2000년1월지2013년12월기간수술치료적125례MCN적림상자료,총결기림상특정.결과 125례MCN중,녀성112례,남성13례,녀:남위8.6:1,년령25 ～ 77세,평균(48 ±14)세.38례(30.4％)환자무증상,87례(69.6％)유증상,이복통최상견(81.6％).종류위우이체미부111례(88.8％),종괴평균직경(6.3±3.4)cm(1～ 20 cm).85례(68.0％)위다방결구.균불여이관상통.술전영상학검사정학진단솔위27.2％.15례MCN재내경초성인도하세침천자행세포혹조직병이학검사,기중14례(93.3％)낭액CEA＞800 μg/L.수술방식이이체미절제술위주,공102례(81.6％).조직병이학분급시MCN반경-중도이형증생110례(88.0％),반중도이형증생2례(1.6％),반침윤성암13례(10.4％).비침윤성MCN술후2、5년생존솔균위100％,침윤성MCN술후2、5년생존솔균위54.0％.결론 MCN주요발생재중년녀성,다위우이선체미부,복통위주요증상,술전진단교위곤난,치료이수술위주,비침윤성MCN가치유.
Objective To analyze the clinical features of mucinous cystic neoplasm (MCN) of pancreas and to improve our understanding of MCN.Methods The clinical data of one hundred and twentyfive patients with MCN who underwent surgical treatment at Changhai Hospital between January 2000 and December 2013 were retrospectively analyzed.Results Among the 125 cases of MCN,the vast majority were female (n =112,89.6％),and only 13 patients were male ; and the mean age was 48 (range,25-77) years old.Thirty-eight (30.4％) patients presented without symptom,while 87 (69.6％) were symptomatic,and abdominal pain was the most common symptom (81.6％).MCNs were located predominantly in the body or tail of the pancreas (n =111,88.8％) and had a mean size of 6.3 cm (range,1-20 cm).About 68.0％ of MCNs were multilocular and none was communicated with pancreatic duct.The preoperative diagnostic accuracy was 27.2％.Fifteen cases underwent FNA,and the fluid CEA ＞ 800 ng/ml was detected in 14 cases (93.3％).The most common surgical procedure performed for MCNs was distal pancreatectomy (n =102,81.6％).Histologically,110 (88.0％) had low-or intermediate-grade dysplasia,2 (1.6％) had high-grade dysplasia,and 13 (10.4％) had invasive carcinoma.The 2-year and 5-year survival rate for non-invasive MCNs were 100％,while the 2-year and 5-year survival rate for MCNs with invasive carcinoma was about 54.0％.Conclusions Patients with MCN are predominantly middle aged women,the lesions are mainly located in the body and tail of the pancreas,abdominal pain is the most common symptom,and the correct preoperative diagnosis is difficult.Surgical resection should be performed for all surgically fit patients and is curative for noninvasive MCNs.