Diagnosis And Treatment Of Pancreatic Serous Cystic Neoplasms And Mucinous Cystic Neoplasms

ObjectiveTo investigate the clinical manifestations diagnosis and treatment characteristics of pancreatic serous cystic neoplasms and mucinous cystic neoplasms,and deepen understanding of these two diseases by studying the clinical data of treated in our hospital.Information and Methods:A retrospective analysis of the clinical data of postoperative pathology of our hospital and surgical treatment in our department,who was confirmed as a patient with pancreatic serous cystic tumor and mucinous tumor.Including the patient’s general information,clinical symptoms and signs,tumor markers,CT data,surgical data,postoperative conditions from January 2010 to December 2017.Divideding into two groups: SCN and MCN by the pathological diagnosis.The t-test is used for continuous variable data with normal distribution,expressed as mean±standard deviation;If the data does not meet the normal distribution,the median is used and the Mann-Whitney U test is applied between the groups.Chi-square test for count data.Results:This study included SCN group(18 cases)and MCN group(22 cases),the ratio of male to female was 1:1.56 and 1:4.5,the average age was 49.4±11.6 years and 46.2±11.3 years;there were symptoms or signs of the patients accounted for 27.8% and 27.3% respectively.The increase in CA19-9 in SCN and MCN groups accounted for 22.2% and 31.8% respectively;the increase in CEA accounted for 22.2% and 63.6% respectively,thedifference was statistically significant;CT manifestations were diverse in lesions.There was no statistically significant difference in Site(P=0.267),mural nodule(P=0.125),sac separation(P=0.412),calcification(P=1.0),presence of solid component(P=0.204),pancreatic tissue the distribution of atrophy(P=0.810)and pancreatic duct expansion(P=0.650);the size of the tumor in terms of the diameter of the tumor(t=3.47,P=0.001),oligo/polycystic(P=0.001),and wall thickness(P=0.013)were statistically significant.There are multiple surgical procedures depending on the specific circumstances of the patient.The average time of operations was 3.74±1.36 h and 3.51±0.69 h respectively,and the mean surgical blood loss was 396.1±181.5ml and 386.5±192.3ml,with no statistically significant difference.The incidence of pancreatic leakage and gastric fistula in the SCN group was 16.7% and 22.2%,respectively.The incidence of pancreatic leakage and gastric fistula in the MCN group was 18.2% and 13.6% respectively,and the difference was not statistically significant.There was no statistically significant difference in hospitalization days(t=0.405,P=0.688).Conclusions: The pancreatic serous cystic neoplasms and mucinous cystic neoplasms are more common in middle-aged female patients,and the lesions are located in the pancreatic body and tail;the abnormal increase of CEA is more common in MCN patients,and the difference is statistically significant;the diagnosis of both depends on images,the examination(CT)has statistically significant differences in the diameter of the cyst、 the number of cysts、 and the thickness of the cyst,which contributes to the identification of SCN and MCN in the pancreas: MCN cysts more than 2 cm in diameter and mostly oligodendrocytes Cystic growth and thicker wall(>2mm).