摘要
目的 总结胰腺囊性肿瘤（PCN）的临床病理特点及诊治方法.方法 回顾性统计和分析中国医学科学院肿瘤医院1980年1月至2012年12月收治的胰腺囊性肿瘤病例,对发病年龄、临床症状、发病部位、治疗及预后进行分析.结果 共统计139例胰腺囊性肿瘤病例,包括38例浆液性囊性肿瘤（SCN）,32例黏液性囊性肿瘤（MCN）,9例导管内乳头状黏液性囊腺瘤（IPMN）,以及60例实性假乳头状瘤（SPN）.PCN发病的男女比例为1：3.63,平均发病年龄46.1岁,46.3%的患者发现肿瘤时无临床症状;有症状的患者中,43.4%的患者的首发症状为腹痛.58.2%的PCN位于胰体尾部,99.5%为单发,超声、CT、MRI等影像学检查的准确率均超过80%.良性PCN患者的5年生存率可达100%;恶性PCN经根治性手术后的1、3、5年生存率分别为70.2%、47.9%、39.5%;而无法手术切除患者的5年生存率仅为16.7%.结论 PCN好发于中年女性,50%无临床症状,最常见为腹痛.PCN大多数为胰体尾的单发肿瘤,常规影像学检查准确率较高.治疗上首选手术切除,恶性PCN患者行根治性切除术后预后较好.
Objective To review our experience in the diagnosis and treatment of pancreatic cystic neoplasms （PCN）. Methods The clinieopathologieal data of PCN were retrospectively analyzed and the relevant medical literatures reviewed. Results A total of 139 cases were treated at our hospital. There were serous cystic neoplasm （ n = 38, SCN ） , mueinous cystic neoplasm （ n = 32, MCN ） , intraduetal papillary mucinous neoplasm （ n = 9, IPMN） and solid pseudopapillary neoplasms （ n = 60, SPN）. The male-to-female ratio was 1 ： 3.63. The average age of disease onset was 46. 1 years old. And 46. 3% of them had no symptom at diagnosis. Among symptomatic ones, there were stomach ache （ 43.4% ） , location in body and tail of pancreas （58.2%） and solitary （99. 5 % ）. The accuracy of ultrasound type B, computed tomography （CT） and magnetic resonance imaging （ MRI ） were above 80% . The 5-year survival rate of benign PCNs was 100%. The 1,3,5-year survival rates of resected malignant PCNs were 70. 2% , 47.9% and 39. 5% respectively. However,the 5-year survival rate of those undergoing palliative surgery was only 16.7%. Conclusions PCNs are more common in females. And the most common clinical presentation is stomach ache. Most PCNs are solitary tumors located in body and tail of pancreas and may be detected by imaging examinations. The prognosis is excellent for benign PCNs and malignant ones undergoing radical resection. However,the prognosis of those undergoing palliative surgery remains poor.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第6期442-445,共4页
National Medical Journal of China
关键词
胰腺囊性肿瘤
诊断
治疗
预后
Pancreatic cystic neoplasms
Diagnosis
Treatment
Prognosis
