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目的本研究的目的在于观察胰腺囊性肿瘤发生率和恶性特征的预测因素。方法本研究患者为本院收治的胰腺囊肿病例,排除假性囊肿病例,分析患者的人口学资料、临床表现、放射学、手术、病理学记录。结果 80例患者平均年龄(47.6±15.5)岁,23例(28.8%)为囊性腺瘤,17例(21.2%)为粘液性囊腺瘤,5例(6.3%)为腺管内乳头状肿瘤,7例(8.8%)为实体假乳头状肿瘤,1例(1.2%)为神经内分泌肿瘤,3例(3.7%)为腺管腺癌,24例(30.0%)为粘液性囊腺癌。恶性病变显著相关因素包括男性(P=0.04)、老年(P=0.0001)、直径超过3cm的囊性肿瘤(P=0.001)、实体肿瘤(P=0.001)、囊壁增厚(P=0.0001)。恶性病变患者绝大多数具有临床症状(26/28,92.9%);相关症状包括腹痛(P=0.04)、体重减轻(P=0.0001)。手术操作主要根据病变部位和范围。结论最常见的胰腺囊肿是粘液性囊肿,老年、男性、较大肿瘤、实体肿瘤、厚壁、有腹痛和消瘦症状是预测囊肿恶化的重要因素。
Purpose The purpose of this study was to investigate predictors of pancreatic cystic tumor incidence and malignancy. Methods In this study, patients with pancreatic cyst admitted to our hospital, cases of pseudocyst were excluded and demographic data, clinical manifestations, radiology, surgery and pathology were analyzed. Results The average age of 80 patients (47.6 ± 15.5 years), 23 (28.8%) were cystadenomas, 17 (21.2%) were mucinous cystadenomas and 5 (6.3%) were intraductal papillary tumors. Seven cases (8.8%) had solid pseudopapillary tumors, one (1.2%) had neuroendocrine tumors, three (3.7%) had adenocarcinoma of the duct, and 24 (30.0%) had mucinous cystadenocarcinoma. Significantly related to malignant lesions included males (P = 0.04), elderly (P = 0.0001), cystic tumors more than 3 cm in diameter (P = 0.001), solid tumors (P = 0.001) . The majority of patients with malignant disease had clinical symptoms (26/28, 92.9%); related symptoms included abdominal pain (P = 0.04) and weight loss (P = 0.0001). Surgical operation mainly based on the site and extent of the lesion. Conclusions The most common pancreatic cyst is myxomatous cyst. Elderly, male, large tumor, solid tumor, thick wall with abdominal pain and emaciation symptoms are important factors in predicting cyst deterioration.