Analysis Of Clinicopathological Characteristics And Prognosis Of Solid-Pseudopapillary Neoplasms Of The Pancreas

PurposeTo analyze the clinicopathological characteristics and prognosis of solid-pseudopapillary neoplasms of the pancreas(SPN)and to explore the differences between the children and adult,male and female.Methods1.The complete clinicopathological and prognostic data of 73 patients with SPN diagnosed by routine staining after operation from January 2008 to June 2016 were collected from the Department of Pathology,the First Affiliated Hospital of Zhengzhou University.2.The clinicopathological characteristics of 73 SPN cases were analyzed retrospectively.The differences between children and adult,male and female were analyzed.3.SPSS 20.0 statistical software was used for data analysis.The tumor sizes of children and adults,the age of male and female patients,were tested byNon-parametric testing of two independent samples.The clinical manifestations,tumor site,clinical staging,pathological features of the tumor and Ki-67 proliferative index were tested by exact probability methods of ? 2 or Fisher's.A level of P <0.05 was considered statistically significant.Results1.Among 73 SPN cases,21cases(28.8 %)were children,15(71.4 %)were female and 6(28.6 %)were male.The age range was 7-17 years old with the average of 13 and median age of 13.The mean diameter of the tumors was 6.8 cm(3.5-14 cm).11 cases(52.4 %)of tumors were located in the head of pancreas,2 cases(9.5 %)in the body of pancreas,7 cases(33.3 %)in the tail of pancreas and 1 case(4.8 %)were multiple lesions located in the head and tail of pancreas.52 cases(71.2%)were adults,of which 42(80.8 %)were female and 10(19.2 %)were male.The age range was 18-68 years old with the average of 35 and median age of 36.The mean diameter of the tumors was 6.47 cm(1.3-14 cm).19 cases(36.5%)of tumors were located in the head of pancreas,7 cases(13.5 %)in the body of pancreas,26 cases(50%)in the tail of pancreas.The patients' gender,tumor site,size,TNM staging,sectioning features,calcification,cholesterol crystal,foamy histiocytes,nuclear atypia,pancreatic parenchyma invasion,perineural invasion,angiovascular invasion,extra-pancreatic invasion,and Ki-67 proliferation index have no statistically significant between the children group and adults group.However,there was significant difference for clinical manifestations(P = 0.010)and tumor necrosis(P = 0.020)between the children group and adults group.2.Among the 73 SPN cases,16 cases(21.9%)were male.The age range was 7-58 years old with the average age of 29 and median age of 26.The mean diameter of the tumors was 6.7cm(3.5-12cm).6 cases(37.5%)were located in the head of pancreas,3 cases(18.8%)in the body of pancreas,7 cases(43.7 %)in the tail of pancreas.For 57 cases(78.1 %)female patients,the age range was 6-68 years old with the average age of 28 and median age of 27.The mean diameter of the tumor was 6.4cm(1.3-14 cm).24 cases(42.1%)of tumor were located in the head of pancreas,6 cases(10.5%)in the body of pancreas,26 cases(45.6 %)in the tail of pancreas,1 case(4.8 %)were multiple lesions located in the head and tail of pancreas.The patients' age,clinical manifestations,tumor site,size,sectioning features,necrosis,calcification,cholesterol crystal,foamy histiocytes,nuclear atypia,angiovascular invasion,Ki-67 proliferation index have no statistically significant between male group and female group.However,there was significant difference for TNM staging(P=0.036),pancreatic parenchyma invasion(P=0.032),perineural invasion(P=0.005),extra-pancreatic invasion(P=0.006)between the male group and female group.3.Among 73 SPN cases,70 patients(95.9%)were tumor-free survival after operation.3 patients(4.1%)had recurrence or metastasis,among which 1 female child with SPN,were found multiple liver metastases in the 27 th month after operation,and 2 male adult patients were found a recurrence in the 10 th and 84 th months respectively after operations.All patients were followed up for an average of 34.8 months(12-99 months)and were currently healthy.There were no differences in recurrence or metastasis of SPN between the group of children and adult,as well as the group of male and female.Conclusions1.The children patients with SPN were more easily to show abdominal discomfort and abdominal mass and more easily to develop tumor necrosis.2.The male patients with SPN were more likely to develop pancreatic parenchyma invasion,perineural invasion and extra-pancreatic invasion.Furthermore,there were more male patients at ? stage compared with the fameal patients.3.SPN had a good prognosis.The 95.9% of patients could be cured after operation,even though 4.1% of patients who had recurrence or metastasis after operation SPN,still have a good prognosis.