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目的探讨胰腺囊性肿瘤的临床病理特征及免疫组织化学特点,以期提高对胰腺囊性肿瘤的认识。方法复习复旦大学附属中山医院1999—2005年间手术切除的92例胰腺囊性肿瘤的临床病理资料和影像资料,根据2002年 WHO 胰腺肿瘤分类标准将其分类。并采用免疫组织化学EnVision 法,借助一组抗体进行鉴别诊断。结果在92例囊性肿瘤中,发病年龄16～80岁,男33例,女59例。其中,浆液性肿瘤18例,黏液性肿瘤14例,导管内乳头状黏液性肿瘤36例,实性假乳头状肿瘤18例,导管腺癌囊性变4例,胰腺内分泌肿瘤囊性变2例。免疫组织化学检测无特异性标记物可以完全区分各类型,常有交叉和重叠。浆液性囊腺瘤表达 MUC-1,黏液性囊性肿瘤表达 MUC-5AC为主,实性假乳头状肿瘤表达α-抗胰蛋白酶、α-抗胰糜蛋白酶、波形蛋白及孕激素受体,导管内乳头状黏液性腺瘤表达 MUC-2,囊性恶性肿瘤主要表达 MUC-1。结论胰腺各类囊性肿瘤在临床症状、影像学表现、组织形态及免疫表型上均有一定特征,但均无特异性,需结合起来综合判断,才能做出正确诊断,以指导临床治疗和预后判断。
Objective To investigate the clinicopathological features and immunohistochemical features of pancreatic cystic tumors in order to improve the understanding of pancreatic cystic tumors. Methods The clinicopathological data and imaging data of 92 cases of pancreatic cystic tumors surgically removed from Zhongshan Hospital Affiliated to Fudan University from 1999 to 2005 were collected and classified according to the 2002 WHO classification of pancreatic tumors. And using immunohistochemistry EnVision method, with a group of antibodies for differential diagnosis. Results In 92 cases of cystic tumors, the age of onset was 16 to 80 years old, including 33 males and 59 females. Among them, serous tumors in 18 cases, mucinous tumors in 14 cases, intraductal papillary mucinous tumors in 36 cases, solid pseudopapillary tumors in 18 cases, ductal adenocarcinoma in 4 cases of cystic degeneration, pancreatic endocrine cystic degeneration in 2 cases . Immunohistochemical detection of non-specific markers can be completely different types, often overlapping and overlapping. MUC-1 was expressed in serous cystadenoma, MUC-5AC was mainly expressed in mucinous cystic tumors, α-antitrypsin, α-antichymotrypsin, vimentin and progesterone receptors were expressed in solid pseudopapillary tumors, MUC-2 was expressed in ductal papillary mucinous adenoma and MUC-1 was expressed in cystic malignant tumor. Conclusion All kinds of cystic tumors of the pancreas have certain characteristics in clinical symptoms, imaging manifestations, histomorphology and immunophenotypes, but they are all nonspecific and need to be combined to make a comprehensive judgment to make a correct diagnosis to guide clinical treatment and Prognosis.