| Objective : To investigate the clinical characteristics,imaging features and pathological characteristics,treatments,prognosis of solid pseudopapillary neoplasms of the pancreas(SPN),in order to discover new available research to further improve the diagnosis and treatment of the disease.Methods:A total of 47 cases confirmed with SPNs by puncture biopsy or postoperative pathology between September 2009 and June 2020 at General Hospital,Ningxia Medical University,were analyzed retrospectively.The clinical characteristics,imaging findings and pathological characteristics,treatments,prognosis and other conditions were summarized,and related factors were analyzed.Combine the clinical data of SPN patients in previous studies and analyze them to draw conclusions.Results:1.Among the 47 patients,6 were males,with an mean age of 44.17 years;41 females,with an mean age of 31.90 years;male to female ratio was 1:6.83;the mean age of male patients was significantly larger than that of females.The incidence rate in the next 5 years is 2.7 times that of the previous 6 years(34:13),and all male patients were diagnosed in the next 5 years.2.All primary SPNs in this study are single.The tumors were located in head and neck in 22cases(46.8%),body and tail in 24 cases(51.1%),retroperitoneal in 1 case(2.1%);cyst-solid in24 cases(51.1%),solid in 15 cases(31.9%),and cystic in 8 cases(17.0%);the incidence of tumors in the head and neck of the pancreas is equal to that in the body and tail.The mean age of patients with tumor diameter smaller than 5cm was significantly older than that of patients with tumor diameter larger than 5cm(30.5 vs 37.8,p =0.041).3.The diagnosis of SPN is mainly based on the pathological results.In this study,31patients(66.0%)had aggressive manifestations and 16 patients(34.0%)had non-aggressive manifestations.Compared with the group with diameter greater than 5cm,the diameter less than5 cm had more malignant potential(p =0.005).According to the immunohistochemistry,Syn and CK-pan have no obvious value in the differential diagnosis of SPN and distinguishing whether SPN is aggressive(p >0.05).4.46 of 47 cases underwent open surgery and only 1 case received puncture biopsy.The median follow-up time was 42 months(range 1–130 months).During the follow-up period,4patients were lost to follow-up,and the remaining 43 patients survived well without tumor recurrences or metastases.Conclusions:1.SPN is a kind of rare pancreatic tumor prone to occur in young women,and its incidence is increasing.Combining this study and previous literature,it is found that the proportion of male patients is gradually increasing,and the mean age is larger than that of females.2.SPN is mostly a single tumor,the incidence of tumors in the head and neck of the pancreas is equal to that in the body and tail.3.Tumor diameter is correlated with the aggressive behavior of SPN.In this study,the tumor diameter of 5cm can be used as one of the indicators of aggressive SPN,and the diameter less than 5cm had more malignant potential.4.Adequate surgical intervention is necessary for SPN and the prognosis after surgery is usually good,with low recurrence and metastasis rates.However,because SPN still has aggressive biological behavior,all patients should be followed up closely for a long time. |
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