摘要
目的 探讨小儿胰腺乳头状囊性实性肿瘤的发病率、临床病理、免疫组化、诊断和治疗特点。方法 手术及病理诊断 1 1例。肿瘤标本进行HE、PAS染色及免疫组化染色 ,抗体选用神经元特异性烯醇化酶 (NSE)、α 1抗胰蛋白酶 (α 1AT)、S 1 0 0、嗜铬粒素A(CgA)、细胞角蛋白 (CK)、上皮膜抗原 (EMA)、胰岛素。结果 1 1例患儿中 ,男 1例 ,女 1 0例 ,年龄 9～ 1 4岁 ,平均年龄 1 1 .1岁。该肿瘤占儿童胰腺实体瘤的 33 .3 %。多以腹痛、腹块为首发症状 ,肿瘤多位于胰头 ,瘤体较大 ,平均直径8.7cm。 6例行肿瘤切除术 ,2例行远端胰腺切除术 ,3例行胰十二指肠切除术。 1 1例患儿生存至今 ,随访 1～ 1 5年。镜下观察 :1 1例肿瘤均以实性区、囊性区及乳头状突起为其特征。免疫组化 :α 1抗胰蛋白酶标志阳性率 1 0 0 % ,神经元特异性烯醇化酶 66 .7%、S 1 0 0 2 8.6 % ,PAS染色均呈阳性。结论 胰腺乳头状囊性实性肿瘤位居儿童胰腺实体瘤第二位 ,多发生于女孩 ,具有良性临床病程 ,手术治愈率高 ,预后良好。胰腺囊实性肿瘤起源尚有争议 。
Objective To estimate the incidence and establish clinicopathological, immunohistochemical, diagnostic and therapeutic features in children with solid cystic papillary tumor (SCPT) of the pancreas in children.Methods Eleven cases ( male 1, female 10 ) aging from 9 to 14 years with a mean of 11.1 years with SCPT were analyzed. The chief complains were abdominal pain and palpable mass. The tumors were often located in the head of pancreas. The mean diameter of tumors was 8.7 ?cm. The procedures employed included local resections (6), distal pancreatectomy (2) and pancreatico-duodenectomies (3). Routine pathological, histochemical, and immuno histochemical methods were utilized to analyze the specimens. Representative blocks of SCPT specimens were immunostained for NSE, α 1 AT, S 100, CgA, CK, EMA and insulin.Results The patients were followed up for 1 to 15 years and were alive postoperatively. Histological examination showed solid with cystic areas and papillary protrusions. Immunohistochemically, the positive rates were 100% for α 1AT, 66.7% for NSE, 28.6% for S 100 and 100% for PAS.Conclusions SCPT may be the second most common pancreatic tumor in children ( 33.3% ). Girls are more frequently affected. The overall prognosis following surgical resection is good. The pathological origin of the tumor remains unclear and requires further investigations.
出处
《中华小儿外科杂志》
CSCD
北大核心
2003年第1期9-11,共3页
Chinese Journal of Pediatric Surgery
