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。
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.
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.
目的总结胰腺实性假乳头状瘤的临床特点及诊治体会。方法回顾性分析2000年5月至2010年5月期间在我科手术治疗并经病理检查证实的8例胰腺实性假乳头状瘤患者的临床资料。结果3例肿瘤位于胰头部者行胰十二指肠切除术; 2例肿瘤位于胰颈部者行单纯肿瘤摘除术; 1例肿瘤位于胰体部者行胰腺中段切除、近端闭合、远端与空肠行吻合术; 2例位于胰尾部者行胰体尾切除联合脾脏切除术。 术中未见腹腔脏器转移。8例患者术后经病理检查均证实为胰腺实性假乳头状瘤。 术后均未行放、化疗。 本组患者随访1~10年（平均5.5年），除2例失访外，其余均健在。 结论胰腺实性假乳头状瘤临床少见，属低度恶性肿瘤，女性多见； CT及MRI是其主要的影像学检查手段； 手术切除预后较好。
ObjectiveTo comparatively analyze the image features of tumorous acute pancreatitis (T-AP) and non-tumorous acute pancreatitis (NT-AP). MethodsSixteen cases of histopathologically proven pancreatic tumors inducing acute pancreatitis and 30 cases of non-tumorous acute pancreatitis were collected, and studied their CT and MRI features. ResultsThere were 16 cases (100%) with focal nodules or masses in T-AP group and none in NT-AP group. The average innerdiameter of main pancreatic ducts in T-AP group was (9.6±6.8) mm, in which 14 cases (87.5%) were dilated. And the average innerdiameter of main pancreatic ducts in NT-AP group was (2.9±0.9) mm, in which 7 cases (23.3%) were dilated. The cases of sinistral portal hypertension (SPH), accompanying cholelithiasis and lymphadenosis between the two groups were 10 (62.5%), 3 (18.8%), 14 (87.5%), and 1 (3.4%), 25 (83.3%), 30 (100%), respectively. The occurrence of manifestation of focal nodules or masses, dilated main pancreatic ducts, SPH, and accompanying cholelithiasis were significantly different (P=0.000) between T-AP and NT-AP groups. While, the differences in enhancement pattern and the occurrence of lymphadenosis between the two groups were not significant (P > 0.05). ConclusionThe image features of T-AP are various. The application of CT and MRI could provide effective diagnostic guidelines for patients with T-AP.
Objective To explore the diagnostic value of miRNAs for pancreatic cancer. Methods PubMed, Scopus, Web of Science, CBM, CNKI, WanFang Data and VIP databases were retrieved from inception to December 31st 2015, to collect diagnostic accuracy studies about miRNAs for pancreatic cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by using the QUADAS-2 tool. Then meta-analysis was performed using MetaDiSc 1.4 and Stata 12.0 softwares. Results A total of 40 articles involving 109 studies were included. The results of meta-analysis showed that the pooled Sen, Spe, +LR, –LR and DOR were 0.81 (95%CI 0.80 to 0.82), 0.77 (95%CI 0.75 to 0.78), 3.15 (95%CI 2.78 to 3.58), 0.27 (95%CI 0.24 to 0.31) and 13.58 (95%CI 10.89 to 16.94), respectively. The AUC of SROC was 0.86 (95%CI 0.84 to 0.88). Subgroups analysis showed that: as to diagnostic accuracy, Caucasian was superior to Asian (AUC=0.89vs. 0.84); multiple-miRNAs profiling-based assays was superior to single miRNA assays (AUC=0.91vs. 0.84). Conclusion Current evidence suggests that miRNA has potential diagnostic value for pancreatic cancer, particularly using multiple miRNAs. Due to limited quality of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo investigate the possible mechanism of cucurmosin on apoptosis in human pancreatic cancer cell line SW1990 in vitro. MethodsThe inhibition of cucurmosin on SW1990 cell was detected by MTT assay, the apoptosis was observed by transmission electron microscope, the apoptosis rate was analyzed by flow cytometry, and the protein level of caspase3 was determined by Western blot. ResultsAfter exposure to cucurmosin at 1.25, 2.50, 5.00, 10.00, 20.00, 40.00, and 80.00 μg/ml for 24, 48, and 72 h, the proliferation of SW1990 cell was inhibited in a time-and dose-dependent manner (Plt;0.05). At 72 h after 40.00 μg/ml cucurmosin treatment, the typical apoptosis changes and apoptotic bodies were observed by transmission electron microscope. After exposure to cucurmosin at 0, 2.50, 10.00, and 40.00 μg/ml for 72 h, the apoptosis rate increased gradually as (0.30±0.11)%, (18.93±1.06)%, (28.00±2.07)%, and (49.93±3.25)%, respectively (Plt;0.05). The expression of caspase-3 protein was elevated gradually (Plt;0.05). ConclusionCucurmosin may induce the apoptosis of pancreatic cancer cell through up-regulating the expression of caspase-3.
【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.
ObjectiveTo summarize of clinical application and progress of duodenum-preserving pancreatic head resection (DPPHR).MethodThe relevant literatures published recently at domestic and abroad about the clinical application and progress of DPPHR were collected and reviewed.ResultsFor the benign lesions, low-grade malignancies and borderline tumors of the head of pancreas, the DPPHR could achieve the same expected therapeutic effect as the classical pancreatoduodenectomy. The DPPHR could reserve the continuity of stomach and duodenum while resecting lesions and improve the symptoms of patients, reduce the reconstruction of digestive tract and the resection of pancreas and surrounding tissues as much as possible, and retain the pancreas-intestinal axis, which was more in line with the physiology of human beings.ConclusionsAt present, DPPHR is worthy of further development and promotion in department of pancreas surgery, but current studies only focus on occurrence of short-term complications after operation. Because patients with benign diseases of pancreatic head have better prognosis and longer survival time after operation, we should pay attention to the long-term complications such as diarrhea, anemia and reflux cholangitis. More clinical studies need in future to be demonstrated superiority of DPPHR in clinical efficacy and to evaluate occurrence of long-term complications and their impact on quality of life of patients with DPPHR by comprehensive analysis of multiple evaluation indicators.