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目的分析儿童和成人胰腺假乳头状肿瘤的临床特点,寻找有恶性潜能的临床特征。方法 2010年10月检索中国万方全文数据库,根据建立的纳入和排除标准,对符合标准的386例和我院2006年1月至2010年6月收治的10例患者的临床资料进行回顾性分析。结果 396例患者中,儿童45例,成人351例。儿童多因扪及腹部包块(46.7%)和腹痛(31.1%)而发现,而成人多是因体检(37.9%)和腹部不适(27.4%)发现。儿童肿块的平均直径较成人大(P<0.05)。儿童肿瘤多位于胰腺头颈部(57.8%),而成人多位于体尾部(65.2%)。单因素变量分析表明门静脉浸润(P<0.01)和肿瘤远处转移(P<0.01)在儿童和成人SPTP良恶性方面的差异均有统计学意义。结论成人和儿童的SPTP有不同的临床特征,门静脉浸润和远处转移可能是潜在的恶性表现,手术完整切除肿瘤并长期随访是较好的治疗策略。
Objective To analyze the clinical features of pancreatic pseudopapillary tumors in children and adults and to find out the clinical features of malignant potential. Methods In October 2010, the author searched China Wanfang full-text database and retrospectively analyzed the clinical data of 386 patients who met the criteria and 10 patients who were admitted to our hospital from January 2006 to June 2010 according to the established inclusion and exclusion criteria . Results Among the 396 patients, 45 were children and 351 were adults. Children were found mostly palpable with abdominal mass (46.7%) and abdominal pain (31.1%), whereas adults were found mostly due to physical examination (37.9%) and abdominal discomfort (27.4%). The mean diameter of children’s lumps was larger than that of adults (P <0.05). Pediatric tumors are mostly located in the head and neck of the pancreas (57.8%), while adults are mostly in the tail (65.2%). Univariate analysis showed that both portal vein infiltration (P <0.01) and tumor distant metastasis (P <0.01) had statistically significant differences between benign and malignant SPTP in children and adults. Conclusion SPTP in adults and children have different clinical features. Portal vein infiltration and distant metastasis may be potential malignant manifestations. Complete surgical resection of the tumor and long-term follow-up are a good treatment strategy.