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目的探讨胰腺浆液性囊性肿瘤(SCNs)的临床病理特征、诊断与鉴别诊断。方法回顾分析14例SCNs的临床病史、实验室检查及影像学特征、组织病理学及免疫表型特点,并复习相关文献。结果 14例SCNs患者年龄33~74岁,平均年龄55.8岁;均为女性;12例以上腹痛、腹胀为主要症状就诊,2例体检发现;5例伴发肝或肾囊肿。14例SCNs亚型中11例微囊型,2例寡囊型,1例实性;其中1例微囊型腺瘤混有黏液性囊性肿瘤成分。镜下肿瘤由大小不等、单个或数个大囊腔组成,囊壁内衬单层立方上皮,胞质透明,核小而圆、居中,无核仁,无核分裂象,囊腔间由粗大的纤维组织分隔;实性型则呈腺泡样排列或中央有小的囊腔,似实性肿瘤。免疫组化:14例上皮标记物CK7、CK19和EMA均(+),Muc-2均(-);9例inhibin和calponin(+);CEA和Muc-5AC(+)各5例。随访19~49个月,未见复发和转移。结论胰腺SCNs是一种少见的胰腺外分泌部肿瘤,结合临床影像学、组织病理学及免疫组化有助于诊断与鉴别诊断。手术切除肿瘤后预后良好,但因部分原发肿瘤良、恶性难以鉴别,需进行定期随访。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of pancreatic serous cystic tumors (SCNs). Methods The clinical history, laboratory examination, imaging features, histopathology and immunophenotypic features of 14 SCNs were retrospectively reviewed. Relevant literatures were reviewed. Results 14 cases of SCNs patients aged 33 to 74 years, mean age 55.8 years; all were women; 12 cases of abdominal pain, abdominal distension as the main symptoms of treatment, 2 cases of physical examination found; 5 cases with liver or renal cysts. Of the 14 SCNs subtypes, 11 were microencapsulated, 2 were oligo-neoplastic and 1 was solid. Among them, 1 was considered as a component of mucinous cystic tumor. Microscopic tumor by the size range, single or several large cysts, wall lined with single-layer cubic epithelium, cytoplasm transparent, small and round nucleus, centered, without nucleolus, no mitotic figure, between the cysts by the coarse Of the fibrous tissue separated; solid type were acinar-like arrangement or central small cysts, like solid tumors. Immunohistochemistry: CK7, CK19, EMA (+) and Muc-2 (-) were detected in 14 cases of epithelial cells, 9 cases of inhibin and calponin (+), 5 cases of CEA and Muc-5AC (+). Follow-up 19 to 49 months, no recurrence and metastasis. Conclusion Pancreatic SCNs is a rare pancreatic exocrine tumor. Combined with clinical imaging, histopathology and immunohistochemistry, it is helpful for diagnosis and differential diagnosis. Surgical resection of the tumor after the prognosis is good, but because some of the primary tumor, malignant difficult to identify, require regular follow-up.