| Objective To study investigated the clinical characteristics,imaging features,laboratory examination,pathological features,treatment and prognosis of solid pseudopapillary tumor of pancreas(SPT).Methods Retrospectively reviewed clinical datas of 32 patients with SPT from the first affiliated hospital of Zhengzhou university,from February 2010 to January 2017,and follow-up.The diagnosis were confirmed by pathologies,intraoperative pathology or postoperative pathology.The clinical characteristics,imaging features,pathological and immunohistochemical features,treatment and prognosis were summarized.Results 1.Among 32 SPT patients,4males and 28 females,male-to-female ratio 1:7.The average age of female was 29.0±14.16 years,the average age of male was 31±13.64 years,female’s was younger than male’s.2.Most of the tumors were solitary,with a minimum diameter of 1.5cm and a maximum diameter of 12.1cm,with an average diameter of 5.4cm,the boundary was clear,mostly for the cystic solid.Tumor location was equally common in head,neck,body and tail,and mainly located in the tail of the pancreas.3.Most of patients had no obvious symptoms,some had symptoms mainly for abdominal distension,abdominal pain,abdominal mass.4.All of the tumor markers were negative before operation,so there was no specificity of tumor markers in the diagnosis of SPT.5.All 32 patients with SPT were examined by CT,and the accuracy rate was84.4%(27/32).12 cases were examined by MRI,and the accuracy rate was 75%(9/12).CT guided fine needle aspiration biopsy in 6 cases,intraoperative rapid frozen in 4 cases,both accuracy rates were 100%.6.The immunohistochemistry: AAT 100% positive,CD56 100% positive,Vimentin 96% positive,β-catenin 95% positive,CD10 90% positive and Cg A 88% negative,Ki-67≤5% 87% positive,PR 83%positive,Syn 78% positive,CK 74% positive,CD99 71% positive,CD34 57% positive,NSE 50% positive,and they can be used for diagnosis of SPT.7.30 patients with SPT patients were underwent resection,pancreatic tumor resection in 7 cases,pancreatic body tail resection in 3 cases,pancreatic body tail(tail of pancreas)and splenectomy in 15 cases,pancreaticoduodenectomy in 4 cases,laparotomy in 1 cases.1 case found when the liver has multiple metastases,can not surgery,1 case of spontaneous rupture of the tumor,anti-shock and hemostasis and other conservative treatment.The main complications were pancreatic pseudocyst and pancreatic fistula.The average length of hospital stay was 22.5 days.One patient was lost follow-up,31 patients were followed up for 6 months to 84 months after the operation,and there were no deaths,no tumor recurrence and metastasis.Conclusions 1.SPT is a rare low-grade malignant tumor of the pancreas,occurring predominantly in young women,although it has low grade malignant,there are still distant organ metastasis and invasion of surrounding organs.2.SPT has no specific clinical manifestations,and the main symptoms are abdominal pain and abdominal mass.3.Tumor markers have no specificity for preoperative diagnosis.4.CT and MRI have important significance in diagnosis of SPT,and can provide detailed information about the size,number,location,surrounding invasion of the tumor.Preoperative biopsy or surgical pathology combined with imaging examinations can guide the choice of surgical approach.5.The main treatment is surgical treatment.The prognosis of the patients with complete resection of the tumor is good and the survival time is long. |
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