目的 总结胰腺实性假乳头状瘤（solid-pseudopapillary tumor of pancreas, SPTP）的诊治经验。方法 回顾性分析我院1999年11月至2007年10月期间收治的6例SPTP患者的临床资料。结果 6例均为女性，其中4例为年轻女性； 术前均未确诊； 行胰腺体尾部切除2例，肿瘤局部切除4例，其中2例加脾切除，术后病理报告确诊为SPTP。 术后无严重并发症，随访1～95个月，无复发和转移。结论 SPTP多发于年轻女性，术中冰冻切片对术中处理提供参考，手术切除为首选治疗方法，预后良好。
Objective To know the abnormal expression of the cell cycle-regulated proteins in pancreatic adenocarcinoma and their effect on tumor cell growth. Methods The expression of p16, p21, Rb and p53 protein in 47 cases were investigated by immunohistochemistry with wet autoclave pretreatment for antigen retriaval. Furthermore, tumor growth index were assessed by a novel anti-ki-67 antibody (ki-s5). Results All the expression of p53, p16, p21 and Rb protein were the nuclear stainning. The positive rates of p53, p16, p21 and Rb protein were 55%, 53%, 74% and 98% respectively. There was negative correlation between of p16, p21 or Rb protein expression and ki-67 growth index. No relation of p53 protein stainning and the expression of p21 protein was found. Conclusion In pancreatic adenocarcinoma, the negative expression of p16 protein and p21 protein may play an important role in tumor cell growth, but tumor proliferation caused by abnormality of Rb protein is rare. The expression of p21 protein was not associated with the expression of p53 protein.
ObjectiveTo study the clinicopathologic features, diagnosis and treatment of papillary cystic and solid tumor of the pancreas (PCSTP).MethodsOne case with PCSTP in our hospital and a review of 60 others from the literatures of the People’s Republic of China, a total of 61 cases were analyzed retrospectively.ResultsThe patients (57 women, 4 men) were of mean age 24.6 (range 9~59) years. The main manifestations included abdominal mass (n=52), pain (n=22) and discomfort (n=10). They were distributed in the head (n=29), neck and body (n=2), body (n=1), body and tail (n=5), tail (n=16) and capsule (n=2) of the pancreas. The other 6 cases occurred outside the pancreas. All the patients underwent surgical therapy. The tumors were identified by postoperative histopathologic examination, 7 of which were malignant (11.5%). The total 1, 3, 5year survival rate was 100%, 96.1% and 86.5% respectively.ConclusionIt is difficult to correctly diagnose the PCSTP before operation because PCSTP is often lack of typical clinical manifestations. The correct diagnosis should depend on histopathologic examination.Complete removal of the PCSTP is the most perfect treatment. PCSTP has a good prognosis.
【Abstract】 Objective To detect the expression of lung resistance protein (LRP) and investigate its significance in pancreatic carcinoma cell lines (SW1990, PCT-2, PCT-3, PCT-4, Aspc-1, Capan-1, Mia-PaCa-2 and Panc-1). Methods Reverse transcription PCR (RT-PCR) and immunocytochemistry (ICC) were carried out to investigate the expression of LRP. Results LRP mRNA was absent in PCT-2 cell line by RT-PCR. Mild to moderate expression level was found in other pancreatic carcinoma cell lines. PCT-4, Aspc-1 and Panc-1 presented the highest LRP mRNA expression level, in contrast, SW1990, PCT-3, Capan-1 and Mia-PaCa-2 showed moderate LRP mRNA expression. The median value was 0.56±0.33. LRP was further validated by ICC. Absent to weak protein expression of LRP was found in PCT-2 and PCT-3. Overexpressed LRP was present in SW1990, Capan-1 and Aspc-1, furthermore, the highest expression of LRP was found in Panc-1, Mia-PaCa-2 and PCT-4 cell lines. Conclusion All these data showed that LRP might play an important role in multidrug resistance of pancreatic carcinoma.
Objective To study the expression and clinic significance of nm23 gene (product of uncleoside ciphosphate kinase) in the pancreatic adenocarcinoma tissues. MethodsSP immunohistochemical method was used to examine the expression of nm23/NDPK in 40 pancreatic adenocarcinoma and 14 normal pancreas tissues.ResultsTwentysix of 40(65%) pancreatic adenocarcinoma showed b immunoreactivity for NDP kinase, whereas 4 of 14 (28.5%) normal pancreatic tissues showed weak immunoreactivity. Significant difference was found between the two groups (P＜0.05). The nm23/NDPK expression levels in pancreatic adenocarcinoma of lower differentiation was higher than those in pancreatic adenocarcinoma of higher differentiation (10/11，90.9%; 2/8, 25%; P＜0.05). Positive staining was associated with higher incidence of lymph node metastasis (10/14, 71.4%) than negative staining (6/19,31.5%, P＜0.05). These results suggested that nm23/NDPK expression was positively associated with lymph node metastasis and aggressiveness. They also suggested that nm23/NDPK expression had negative correlation with the extent of histologic differentiation. Conclusion nm23/NDPK can serve as a marker for malignant potentiality and indicate the prognosis of pancreatic adenocarcinoma.
目的 探讨胰腺恶性纤维组织细胞瘤的诊断及治疗。方法 对兰州大学第一医院收治的1例胰腺恶性纤维组织细胞瘤患者，结合国、内外文献对其临床特点，影像学、病理学及免疫组化特征、治疗和预后进行分析。结果 行胰腺肿瘤切除，术后医用直线加速器采取三维适形精确放疗，随访9个月，未见肿瘤复发。结论 胰腺恶性纤维组织细胞瘤恶性度高，易复发、转移，生存率低，诊断主要依靠病理和免疫组化检查。外科手术联合放射治疗可延长生存时间和延缓肿瘤的复发。
ObjectiveTo investigate the expression of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) in human pancreatic adenocarcinoma and their correlation with clinicobiological behavior.MethodsThe expression of COX-2 and VEGF in 51 cases of human pancreatic ductal adenocarcinoma were detected with immunohistochemistry of Envision.ResultsExpression of COX-2 and VEGF in pancreatic ductal adenocarcinoma were 74.5% and 68.6%, respectively; no expression of COX-2 and VEGF in adjacent normal tissue was detected. Both COX-2 and VEGF expression in clinical stage Ⅲ-Ⅳ were much higher than those in clinical stage Ⅰ-Ⅱ, and also higher in positive group of lymph node metastasis than in negative group as well (Plt;0.05). None of them had relation with histological grades, age, sex, tumor size and location. The expression of COX-2 was closely correlated with VEGF (r=0.411, Plt;0.01).ConclusionCOX-2 and VEGF may play a pivotal role in tumorigenesis and tumor progression in pancreatic cancer, they may provide new targets for therapy of pancreatic cancer.
Objective To discuss the methods of diagnosis and treatment of cystic neoplasms of pancreas. Methods Demographic data, clinical manifestations, diagnostic exams, surgical procedures, pathological diagnosis, postoperative complications, and follow-up data of 29 patients with cystic neoplasms of pancreas were analyzed retrospectively. Results There were 8 （28%） serous cystic tumors （SCN）, 12 （41%） mucinous cystic tumors （MCN）, 3 （10%） intraductal papillary mucinous tumors （IPMN）, and 6 （21%） solid pseudopapillary tumors （SPT）. Eight cases of SCN, 7 cases of MCN, 1 case of IPMN, and 5 cases of SPT were all benign. The ages of the patients were from 15 to 78 years〔average, （49±17）years〕and all tumors were more common in female （76%, 22/29）. Twenty-three cases of 29 patients were performed operations, 22 cases were underwent surgical resection, and 1 case was performed exploration and biopsy. There was no surgery-related death. The rest 6 cases were not performed operation. Twenty-one cases followed-up for 6 months to 8 years 〔average, （2.7±2.3） years〕, 8 cases didn’t followed-up. Sixteen cases with surgical resection had no recurrence during follow-up period, 1 case performed exploration and biopsy died in 1 year after operation, and 4 cases of SCN without surgery didn’t deteriorate. Conclusions The most common cystic neoplasms of pancreas are mucinous and serous cysts. These tumors are more frequent in female. Although almost all serous cysts are benign, 42% of mucinous cysts are malignant. Misdiagnosis may delay appropriate treatment and increase mortality. The resection rate of pancreatic cystic tumor is high, and the prognosis is good after radical resection.
Objective To evaluate feasibility and clinical application value of laparoscopic spleen-preserving distal pancreatectomy (LSPDP). Method The clinical data of 17 patients underwent LSPDP from January 2015 to June 2017 in this hospital were retrospectively analyzed. Results The LSPDP was successfully completed in the 17 cases, with Kimura procedure and Warshaw procedure were performed in the 12 cases and 5 cases, respectively. The operative time was (218±60) min, the intraoperative blood loss was (136±114) mL, the time to get out of bed after surgery was (1.4±0.6) d, the postoperative fasting time was (2.0±0.8) d, and the postoperative hospital stay was (13.4±5.7) d. The rate of the postoperative pancreatic fistula was 17.6% (3/17). The spleen infarction occurred in the 2 cases following the Warshaw procedure. The pathologic examination showed that there were 2 patients with the serous cystadenoma, 7 patients with the mucinous cystadenoma, 3 patients with the solid pseudo-papillary tumor, 3 patients with the intraductal papillary mucinous cystadenoma neoplasm, and 2 patients with the insulinoma. All the patients were followed-up for 5 to 26 months (average 13 months), and the perigastric varice occurred in 1 patient, no recurrence or spleen infarction occurred during the following-up. Conclusion LSPDP is a safe, feasible and effective method with less injury and rapid recovery.
【Abstract】Objective To investigate the expression of extracellular matrix metalloproteinase inducer(EMMPRIN)，matrix metalloproteinase-1(MMP1)，MMP9，tissue inhibitors of metalloproteinase-1(TIMP1) and the mast cell count (MCC) and to detect their clinicopathologic significance and relationship in pancreatic cancer tissues. Methods Immunohistochemical method of avidin-biotin complex was used for those 5 targets on the routinely paraffinembedded sections of surgical resected specimen of 51 cases with pancreatic carcinoma. Results The positive rates of EMMPRIN，MMP1，MMP9 and TIMP1 were 56.9%，54.9%，60.8% and 49.0% and its scoring were 2.5±1.5，2.3±1.9，2.4±1.6 and 1.9±1.6 respectively. The mean of MCC was (16.1±6.8)/HP in total cases. The positive rates or scorings of EMMPRIN，MMP1，MMP9 and MCC were significantly lower in high differentiated or without-metastatic cases than in low differentiated or with-metastatic ones(P＜0.05 or P＜0.01), and those targets (except MCC and scoring of MMP9) of middle differentiated ones were lower than those of low differentiated while that of TIMP1 was opposite(P＜0.01). The MCC showed significantly higher in the positive cases of EMMPRIN, MMP1 and MMP9 or negative cases of TIMP1 than in the negative ones of EMMPRIN, MMP1 and MMP9 or positive ones of TIMP1. The closely positive correlations were found among the MCC and the scoring of EMMPRIN, MMP1 and MMP9. The closely negative correlations existed among the scoring of TIMP1 and the other four targets.Conclusion The MCC and the expressions of EMMPRIN, MMP1, MMP9 and TIMP1 might be important biological markers for reflecting the progression and the prognosis of pancreatic carcinoma. They might have co-regulated effects on the potentials of invasion and metastasis of pancreatic carcinoma or other malignant lesions.