胰腺黏液性囊性肿瘤的临床病理特点及良恶性影响因素分析

侯丽艳; 贾如江; 王秀超; 兰春根; 尹清臣

doi:10.3969/j.issn.1001-5256.2017.08.021

胰腺黏液性囊性肿瘤的临床病理特点及良恶性影响因素分析

DOI: 10.3969/j.issn.1001-5256.2017.08.021

1. 邯郸市中心医院
2. 天津医科大学附属肿瘤医院

详细信息

中图分类号: R735.9
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出版历程
- 收稿日期: 2017-01-05
- 出版日期: 2017-08-20

Clinicopathological features of pancreatic mucinous cystic neoplasm and influencing factors for its malignancy

Handan Central Hospital

摘要

摘要: 目的探讨胰腺黏液性囊性肿瘤（MCN）的临床病理特点并分析其良恶性的影响因素。方法回顾性分析2013年1月-2015年12月天津市肿瘤医院和邯郸市中心医院收治的经术后病理证实的43例胰腺MCN患者的临床资料,根据病理诊断结果分为良性组（包括黏液性囊腺瘤及胰腺MCN伴低/中级别异型增生）和恶性组（包括MCN伴高级别异型增生及MCN伴浸润癌）。总结2组患者的临床病理特点和影像学特征,分析胰腺MCN发生恶变的相关危险因素。计量资料组间比较采用独立样本t检验,计数资料组间比较采用χ2检验,多因素分析采用logistic回归分析。结果 43例患者中男14例,女29例,年龄2281岁,中位年龄58.53岁。有临床症状的患者30例（69.8%）。肿瘤最大直径4.8 cm（1.216 cm）。肿瘤位于胰头部18例（41.9%）,胰颈3例（7.0%）,体尾部20例（46.5%）,2例（4.6%）为多发。2组患者在年龄、肿瘤性质、肿瘤部位、质地、肿瘤标志物、囊壁不均质强化、伴有实性成分不均质强化、囊壁厚度>0.2 cm上差异均有统计学意...
- 胰腺疾病 /
- 肿瘤,囊性,黏液性和浆液性 /
- 病理状态,体征和症状 /
- 危险因素
Abstract: Objective To investigate the clinicopathological features of pancreatic mucinous cystic neoplasm ( MCN) and influencing factors for benign and malignant MCN. Methods A retrospective analysis was performed for the clinical data of 43 patients with pathologically confirmed pancreatic MCN who were treated from January 2013 to December 2015, and according to the results of pathological diagnosis, the patients were divided into benign group ( mucinous cystadenoma and pancreatic MCN with low/middle-grade dysplasia) and malignant group ( MCN with high-grade dysplasia and MCN with invasive carcinoma) . The clinicopathological features and radiological features were summarized, and the risk factors for malignant transformation of pancreatic MCN were analyzed. The independent samples t-test was used for comparison of continuous data between groups, the chi-square test was used for comparison of categorical data between groups, and a multivariate logistic regression analysis was used to identify risk factors. Results There were 14 male and 29 female patients aged 22-81 years ( median 58. 53 years) . Of all patients, 30 ( 69. 8%) had clinical symptoms. The maximum tumor diameter was 4. 8 cm ( range 1. 2-16cm) . Of all patients, 18 ( 41. 9%) had MCN in the head of the pancreas, 3 ( 7. 0%) had MCN in the neck of the pancreas, 20 ( 46. 5%) had MCN in the body and tail of the pancreas, and 2 ( 4. 6%) had multiple MCNs. There were significant differences between the two groups in age, tumor nature, tumor location, texture, tumor markers, heterogeneous enhancement of the cyst wall, heterogeneous enhancement of solid components, and cyst wall thickness > 0. 2 cm ( all P < 0. 05) . The multivariate logistic regression analysis showed that age and increased tumor markers were independent predictive factors for malignant pancreatic MCN ( both P < 0. 05) . Conclusion Age, tumor nature, tumor location, texture, increased tumor markers, heterogeneous enhancement of the cyst wall, heterogeneous enhancement of solid components, and cyst wall thickness > 0. 2 cm are important features of malignant pancreatic MCN, and age and increased tumor markers are risk factors for malignant pancreatic MCN.
- pancreatic diseases /
- neoplasms, cystic, mucinous, and serous /
- pathological conditions /
- signs and symptoms

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参考文献(15)

[1] Editorial Board of Chinese Journal of Pancreatology.Consensus on pancreatic cystic neoplasm in China (draft in 2013, Shanghai) [J].Chin J Pancreatol, 2013, 13 (2) :79-90. (in Chinese) 中华胰腺病杂志编辑委员会.我国胰腺囊性肿瘤共识意见 (草案2013, 上海) [J].中华胰腺病杂志, 2013, 13 (2) :79-90.

[2]BUERKE B, DOMAGK D, HEINDEL W, et al.Diagnostic and radiological management of cystic pancreatic lesions:Important features for radiologists[J].Clin Radiol, 2012, 67 (8) :727-737.

[3]LI L, SUN B, ZHANG GQ, et al.Risk factors analysis of benign and malignant pancreatic cystic neoplasm and prognosis[J].Chin J Dig Surg, 2016, 15 (6) :562-566. (in Chinese) 李乐, 孙备, 张广权, 等.影响胰腺囊性肿瘤良恶性及预后的危险因素分析[J].中华消化外科杂志, 2016, 15 (6) :562-566.

[4]JANG KT, PARK SM, BASTURK O, et al.Clinicopathologic characteristics of 29 invasive carcinomas arising in 178 pancreatic mucinous cystic neoplasms with ovarian-type stroma:implications for management and prognosis[J].Am J Surg Pathol, 2015, 39 (2) :179-187.

[5]CRIPPA S, SALVIA R, WARSHAW AL, et al.Mucinous cystic neoplasm of the pancreas is not an aggressive entity[J].Ann Surg, 2008, 247 (4) :571-579.

[6]TANAKA M, FERNNDEZ-DEL CASTILLO C, ADSAY V, et al.International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas[J].Pancreatology, 2012, 12 (3) :183-197.

[7]LEWIS GH, WANG H, BELLIZZI AM, et al.Prognosis of minimally invasive carcinoma arising in mucinous cystic neoplasms of the pancreas[J].Am J Surg Pathol, 2013, 37 (4) :601-605.

[8]YOON WJ, BRUGGE WR.The safety of endoscopic ultrasoundguided fine-needle aspiration of pancreatic cystic lesions[J].Endosc Ultrasound, 2015, 4 (4) :289-292.

[9] SUN JS, ZHANG YZ, ZHOU YY, et al.Mucinous cystic neoplasm of the pancreas:clinical features of 125 patients[J].Chin J Pancreatol, 2014, 14 (5) :321-325. (in Chinese) 孙金山, 张永镇, 周益胰, 等.腺黏液性囊性肿瘤125例临床特征分析[J].中华胰腺病杂志, 2014, 14 (5) :321-325.

[10]HAN KW, HA R, KIM KK, et al.Surgical management and results for cystic neoplasms of pancreas[J].Korean J Hepatobiliary Pancreat Surg, 2013, 17 (3) :118-125.

[11]YAN L, CHEN YL, ZHANG WZ, et al.Clinicopathological and CT features of mucinous cystic neoplasms of the pancreas[J].Chin J Oncol, 2014, 36 (6) :446-450. (in Chinese) 严力, 陈永亮, 张文智, 等.胰腺黏液性囊性肿瘤的临床病理特点和CT影像学特征[J].中华肿瘤杂志, 2014, 36 (6) :446-450.

[12]LI XD, LIU YJ, ZHU LW, et al.Clinical correlative factors of malignant cystic pancreatic tumors[J].Chin J Dig Surg, 2012, 11 (4) :343-345. (in Chinese) 李晓丹, 刘毓键, 朱理玮, 等.恶性胰腺囊性肿瘤的临床相关因素分析[J].中华消化外科杂志, 2012, 11 (4) :343-345.

[13]ZHANG JL, GE CL.Clinical features of pancreatic cystic neoplasms and its therapeutic strategy[J].J Clin Hepatol, 2016, 32 (5) :860-863. (in Chinese) 张家利, 葛春林.胰腺囊性肿瘤的临床特点及治疗策略[J].临床肝胆病杂志, 2016, 32 (5) :860-863.

[14]LEWIS GH, WANG H, BELLIZZI AM, et al.Prognosis of minimally invasive carcinoma arising in mucinous cystic neoplasms of the pancreas[J].Am J Surg Pathol, 2013, 37 (4) :601-605.

[15]BAI X, YE L, ZHANG Q, et al.Surgical resection and outcome of pancreatic cystic neoplasms in China:analysis of a 16-year experience from a single high-volume academic institution[J].World J Surg Oncol, 2014, 12 (5) :228-232.

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