CAJ | 학술논문

目的汇总分析国内报道的胰腺实性假乳头状瘤(SPTP)病例,探讨国人SPTP的流行病学、临床特点及诊治策略.方法以“胰腺实性假乳头状瘤”、“胰腺乳头状囊性肿瘤”、“胰腺乳头状上皮肿瘤”、“胰腺实质性囊性肿瘤”、“Frantz瘤”等为检索词,电子检索2001年1月至2011年12月间中国生物医学期刊文献数据库和中国生物医学文献数据库,总结分析纳入文献的临床资料.结果共纳入117篇文献1180例患者,其中女性1054例,男性126例,男女比例为1∶8.37.发病年龄9～ 83岁,平均29岁.有详细临床资料者1172例,临床表现以腹部不适(526例,44.9％)、体检发现肿瘤就诊(464例,39.6％)、扪及腹部肿物(131例,11.2％)为主.实验室及影像学检查无特异性.肿瘤直径1.3～30 cm,平均7.84 em,位于胰头407例(36.8％),胰颈96例(8.7％),胰体尾部587例(53.1％).1116例患者接受治疗,其中1107例(99.2％)行手术切除.病理检查628例(57.0％)为良性,306例(27.8％)表现为恶性行为,浸润性生长侵及周围器官及组织.随访977例,随访时间为1个月至13年,42例(4.3％)复发或转移,其中24例病死.结论 SPTP是一种少见的低度恶性肿瘤,部分呈恶性表现,多发于年轻女性,临床表现、实验室及影像学检查无特异性,病理检查可确诊,手术治疗为首选,预后好.
목적 회총분석국내보도적이선실성가유두상류(SPTP)병례,탐토국인SPTP적류행병학、림상특점급진치책략.방법 이“이선실성가유두상류”、“이선유두상낭성종류”、“이선유두상상피종류”、“이선실질성낭성종류”、“Frantz류”등위검색사,전자검색2001년1월지2011년12월간중국생물의학기간문헌수거고화중국생물의학문헌수거고,총결분석납입문헌적림상자료.결과 공납입117편문헌1180례환자,기중녀성1054례,남성126례,남녀비례위1∶8.37.발병년령9～ 83세,평균29세.유상세림상자료자1172례,림상표현이복부불괄(526례,44.9％)、체검발현종류취진(464례,39.6％)、문급복부종물(131례,11.2％)위주.실험실급영상학검사무특이성.종류직경1.3～30 cm,평균7.84 em,위우이두407례(36.8％),이경96례(8.7％),이체미부587례(53.1％).1116례환자접수치료,기중1107례(99.2％)행수술절제.병리검사628례(57.0％)위량성,306례(27.8％)표현위악성행위,침윤성생장침급주위기관급조직.수방977례,수방시간위1개월지13년,42례(4.3％)복발혹전이,기중24례병사.결론 SPTP시일충소견적저도악성종류,부분정악성표현,다발우년경녀성,림상표현、실험실급영상학검사무특이성,병리검사가학진,수술치료위수선,예후호.
Objective To summarize and analyze data of solid pseudopapillary tumor of pancreas (SPTP) in China,and investigate its epidemiology,clinical features,diagnosis and treatment.Methods Retrieval of Chinese Medical Current Contents and China Biology Medicine disc by the key words of solid pseudopapillary tumor of the pancreas,papillary cystic tumor of the pancreas,pancreatic papillary epithelial tumor,cystic solid tumor of pancreas and Frantz tumor were performed,and relevant literatures were included.Results A total of 1180 SPTP patients from 117 articles were involved.There were 1054 women and 126 men and the ratio of male to female was 1:8.37.The average age was 29 years old (range 9 ～83 years).Detailed clinical information was available for 1172 cases,and the main clinical manifestations included abdominal discomfort (n=526,44.88％),medical check-up (n=464,39.59％),abdominal mass (n=131,11.18％).Laboratory and imaging tests were non-specific.The tumors size was 1.3～ 30 cm with a mean value of 7.84 cm.Four handreds and seven (36.8％) cases were located in pancreatic head,96 (8.7％)were in pancreas neck and 587 (53.1％) were in the body and tail of pancreas.Eleven handreds and sixteen patients received treatment,and the resection rate was 99.2％ (n =1107).Pathological examination showed that 628(57.0％) cases were benign and 306 (27.8％) were presented as malignant behavior,mainly as infiltrative growth and invasion of the surrounding organs,vessels.Nine handreds and seventy-seven cases were followed up (ranging from 1 month to 13 years),and re-occurrence or metastasis were detected in 42 cases (4.3％) and 24 patients died.Conclusions Solid pseudopapillary tumor of pancreas is a rare pancreatic tumor with low-grade malignant potential,and part of this tumor may present as malignant behavior and it primarily affects young females.No characteristics in clinical manifestations,laboratory and imaging tests are found.Pathological examination can confirm the diagnosis.Surgical resection is the therapy of choice and the prognosis is good.