| Objective:To investigate the clinical diagnosis and treatment points and prognostic risk factors of solid pseudopapillary tumors of the pancreasMethods:1.Research object:This study is a clinical retrospective study.All clinicopathological data of patients with SPT confirmed by postoperative disease detection from January 2010 to December 2018 were collected from the First Affiliated Hospital of Kunming Medical University and the Second Affiliated Hospital of Kunming Medical University.2.Research study:The general information,clinical manifestations,laboratory examination,imaging examination,treatment,postoperative complications,postoperative pathological examination and postoperative follow-up data of SPT patients were retrospectively analyzed,and the clinical diagnosis and treatment key points and prognostic risk factors of SPT were summarized.SPSS 19.0 statistical software package was used for data analysis in this study.All measurement data were expressed as mean standard deviation(x±s).Comparison between groups was performed by independent t test.The chi-square test or the chi-square test of the row multiplication list was used to compare the counting data.Kaplan-Meier survival analysis was performed to determine the risk factor for SPT recurrence after surgery.P<0.05 was considered statistically significant.Results:1.A total of 54 patients were included in this study,including 9 male patients aged 27.00±16.67 years.45 female patients were 29.44±10.60 years old,and the ratio of male and female sex was 1:5.There was a statistically significant difference in Ki 67 proliferation index between male and female patients(P=0.016).There were 9 cases of children and 45 cases of adults,and the distribution of gender(P=0.008)and tumor diameter(P=0.000)were statistically different between different age groups.There were 8 patients in the high invasive group and 46 patients in the low invasive group.The statistical results showed that there was no statistical difference among the variables in the different aggressive groups(P>0.05).2.The diagnostic accuracy rates of ultrasound,CT,MRI for SPT were 3.92%,29.41%and 41.18%,respectively.The diagnostic accuracy of MRI was the highest,and the difference was statistically significant(P<0.01).3.All the 54 patients survived after surgical treatment,and the follow-up time was 34.32±28.38 months.One patient occurred recurrence 3 months after surgery due to the margin did not reach RO.Another patient had tumor recurrence 26 months after surgery.There was no evidence of tumor recurrence in the 2 patients after the second operation.4.Pathological examination was performed on all surgical resected specimens of the patients.The tumors of 48 patients were cystic solid masses,and 6 patients were total solid masses.There were 4 patients had capsular invasion,1 patient had perineural invasion,1 patient had vascular invasion,and 3 patients had fat invasion.Lymph node dissection was performed in 10 patients,and no lymph node metastasis was found.In the immunohistochemical results,the positive expression rates of Vim,PR,CD56,CgA,CD10 andβ-catenin were 97.72%,92.31%,97.78%,4.55%,89.13%and 100.00%,respectively.5.Positive surgical margin was a risk factor for recurrence of SPT after surgery.Conclusions:1.SPT is a t low malignancy pancreatic tumor that tends to occur in young women.2.The preoperative diagnosis of SPT mainly depends on imaging examination,and the diagnostic accuracy of MRI is higher than CT and ultrasound.3.Surgical resection is the main treatment for SPT,and postoperative prognosis of patients is good.Positive margin is a risk factor for postoperative recurrence.4.In the absence of distant metastasis,local resection of the tumor can achieve the goal of radical treatment.5.SPT has potential metastasis and recurrence after surgery,and postoperative patients should be followed up regularly. |
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