The Clinical Characteristics About 45 Cases Of Pancreatic Cystic Neoplasms

Objective:To investigate the clinical characteristics of pancreatic cystic neoplasms and summary the experience of diagnosis and treatment of them.Methods:Current retrospective cohort study was conducted from 45 hospitalized patients in the First Affiliated Hospital of Guangxi Medical University between October 2004 and December 2014. All the patients selected had been operated and were diagnosed with pancreatic cystic neoplasms by pathology. According to the pathological results,pancreatic cystic neoplasms can be divided into four types:serous cystic neoplasm, mucinous cystic neoplasm, intraductal papllary mucinous neoplasm and solid pseudopapillary neoplasm. all the features in four types were compared as below:The features of age, gender, clinical features, location and size of tumor, serum tumor markers levels, hepatitis B virus infection, imaging examination, histopathology, and operation mode. Further, the differences between the benign and malignant pancreatic cystic neoplasms were investigated.Results:1.Among 45 cases of pancreatic cystic neoplasms,14 were males and 31 were females, the ratio of male to female is about 1:2.37 benign tumors and 8 malignant tumors, the ratio of benign tumors to malignant tumors is about 4:1.2.The average of age of SCN, MCN, IPMN, SPN at onset was 46.0±13.30, 48.63±7.73,56.40±14.94,31.41±18.37, respectively. Comparing the average age of SPN with SCN, MCN, IPMN average age at onset, respectively, the results were statistically significant (P<0.05). The average age of benign and malignant pancreatic cystic neoplasms patients were 37.65±17.51 and 54.75±12.17 respectively. Which was statistically significant when compared the results(P<0.05).3.Clinical features:all the 45 patients had clinical features as below: abdominal pain(24 cases),6 cases were with abdominal distension(6 cases), abdominal mass(11 cases), jaundice(4 cases), weight loss(7 cases), no symptoms(10 cases). By comparison, there were no significance statistically between benign and malignant PCN(P>0.05).4.Two serum tumor markers(CA199 and CEA) in benign and malignant PCN groups were analysed, CA199 was 71.81±37.02 U/ml in benign group and was 413.35±176.07 U/ml in malignant group, while CEA 1.37±1.00 ng/ml in benign group and 10.97±7.48 ng/ml in malignant group. By comparison, the results showed the markers CA199 and CEA between benign and malignant groups were statistically significant (P<0.05). The positive rate of serum hepatitis B core antibody level in SCN、MCN、IPMN、SPN and control group were respectively 100%、0%、60.0%、54.55% and 52.04%.5.The rate for detection of PCN by CT and MRI were 68.42% and 63.64%,respectively. And the coincidence rate for pathological results were 28.95%、27.27%. However,2 cases were detected in 6 cases by EUS. No detection were found by PET/CT.6.43 patients have had operations to remove the tumors. Other than the lost patients,30 patients(27 benign cases and 3 malignant cases) were remained to follow up. Among them, three patients had a recurrence(one benign MCN, one malignant MCN, one SPN), one patient died from pulmonary disease,and The other 26 cases had no recurrences.Conclusion:1.PCN was generally appeared in women and developed benignly.SPN was the most common type in the four types of PCN, which was the youngest age at onset.2.PCN developed malignant with older age and higher CA199 and CEA.3. The treatment of pancreatic cystic neoplasms was mainly surgery. But after surgery, the recurrence occurs both in benign and malignant PCN.