胰腺囊实性假乳头状肿瘤6例临床病理学分析(1)
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【摘要】目的;观察胰腺囊实性假乳头状肿瘤(CSTP)的临床病理及免疫组化特点及预后的关系。方法:6例CSTP常规石蜡切片、HE染色、免疫组化(S-P)法染色观察。结果:6例术后无复发,肿瘤较大,大部有包膜,由实性与囊性坏死组织组成。镜下见肿瘤细胞形态大小较一致,核圆形或卵圆形,核异型性不明显,核分裂象少见,可见肿瘤细胞绕血管成乳头状排列。免疫组化:6例AACT(+)、Vimentin(+),4例NSE(+),SMA、S-100,均阴性。结论:胰腺囊实性假乳头状肿瘤(CSTP)是好发生于年轻女性的低度恶性肿瘤,手术切除有较高的治愈率。
【关键词】胰腺肿瘤;假乳头状肿瘤;免疫组化;预后
The analysis of clinicopathological features in 6cases of pancreas solid-cysticpseudopapillary tumor
Zhen Hong-wei
Department of pathology, YiShui central hospital, LinYi city 276400
【Abstract】Objective To investigate the immunohistochemical features of solid-cystic pseudopapillary tumor in pancreas (SCPT) and impacts on clinical prognosis. Methods Samples collected from 6cases of CSTP were stained by histological (H-E stains) and immunohistochemical method(S-P method) Results: All the 6 patients were recovered without recurrence after tumor resection. The tumors were large in size and great messily allencapsulated. The section of the tumor showed solid alternately with cystic. The microscopy observation showed tumor cells were in uniform, the nuclei were oval, round without magnificent alypia and mitotic were rarely to find. The tumor cells were arrayed in Psudopapillary structure with a fibrovascular core. Immunohistochemical results were as bellow:the tumor cells were negative in Des、S-100,and were positive in Syn ,Vimentin(+), EMA(-);additionally 6cases AACT(+),4cases NSE(+),6case Vimentin(+),.Conclusion: SCPT is a low potential m alignancy tumor and found most frequently in middle-aged women without recurrence after tumor resection.
【Key words】Pancreatic neoplasm; Solid-cystic pseudopapillary; Immunohistochemisty; Prognosis
胰腺囊实性假乳头状肿瘤(CSTP)常发生于青春期和年轻妇女,过去曾被误认为内分泌肿瘤或囊性肿瘤,又称乳头状囊性肿瘤,实性乳头状瘤等。2000年WHO国际肿瘤组织分类将其明确为胰腺交界性或恶性潜能未能确定的肿瘤,多数手术切除能治愈,与其他胰腺肿瘤不同,由于认识不足,国内外报道较少,我院自2003年~2009年共发现6例,通过病理细胞学、组织化学及免疫组化对CSTP进行探讨,以提高对CSTP的认识。
1材料与方法
1.1材料 收集我院2003年~2009年间的胰腺手术标本,复习原切片确诊为胰腺囊实性肿瘤,6例均获取随访资料。
1.2方法 所有标本均常规中性福尔马林固定、石蜡包埋、切片、HE染色,免疫组化采用(S-P)法,所有抗体及试剂盒均购自福州迈新生物技术公司。α-1AT、Vimentin、EMA、NSE、SYN、CgA、SMA,以上抗体均为即用型工作液,阳性颗粒均定于细胞浆,并设阳性对照片。
2临床资料
6例中,男性1例,女性5例,男女之比为1:5;年龄18~24岁,平均年龄21岁,5例伴上腹不适,,3例偶然发现上腹部肿块,其中1例为腹膜后肿物,但与胰腺有粘连;1例位于胰头部,4例位于胰体尾部,临床无血糖异常及血尿淀粉酶异常改变。B超示胰腺区占位性病变;CT示不同比例囊实性成分组成,不均匀混杂信号软组织肿块影,周边有高密度纤维包膜,随访结果均未见复发或转移。
3病理检查 ......
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