摘要目的 分析胰腺腺泡细胞癌的临床病理特征及蛋白表型.方法 收集2001年1月至2011年1月收治的8例胰腺腺泡细胞癌病例,分析其临床病理特征,采用免疫组化法检测肿瘤的蛋白表型,并进行随访.结果 8例胰腺腺泡细胞癌病例均为男性,中位年龄47岁.肿瘤位于胰头部和胰体尾部各4例,大小平均为4.5 cm×4.0 cm ×3.2 cm,切面灰黄、灰红色,呈实性或囊实性,体积较大者常伴有出血、坏死.镜下见肿瘤细胞排列呈腺泡状、梁索状或实性片巢状,胞质丰富、嗜酸性,核圆形、卵圆形,轻度异型.免疫组化显示癌细胞低分子量细胞角蛋白(CAM5.2)、α1-抗胰蛋白酶(α1-AT)、抗胰糜蛋白酶(α1-ACT)蛋白表达呈弥漫阳性,CA19-9、CEA,上皮型钙粘蛋白(E-cad)、β-连环素(β-cat)和粘蛋白-1( MUC-1)呈灶性阳性,AFP、神经特异性烯醇化酶(NSE)、突触素(Syn)和铬粒素A(CgA)仅少数瘤细胞呈阳性表达.7例获得随访,1例因术后胰漏伴腹腔感染病死,发生肝转移4例,其中2例病死.结论 胰腺腺泡细胞癌是一种少见的胰腺上皮源性恶性肿瘤,有其特征性的蛋白表型.

abstractsObjective To investigate the clinicopathological features,immunohistochemical phenotype of pancreatic acinar cell carcinoma.Methods Eight cases of pancreatic acinar cell carcinoma admitted to our hospital from January 2001 to January 2011 were retrospectively analyzed. The clinicopathological characteristics,and immunohistochemical staining for phenotype were analyzed,then the follow-up data were summarized.Results All 8 patients with pancreatic acinar cell carcinoma was male,with a median age of 47 years old.Tumors were located in the pancreatic head in 4 patients,pancreatic body and tail in 4 patients.The average tumor size was 4.5 cm × 4.0 cm × 3.2 cm,the section appeared as gray or gray-red and presented as solid or cystic lesions.Larger tumors were often accompanied by hemorrhage and necrosis.Microscopically,the tumor cells arranged in acinic,cord,trabecular or solid nests.The cytoplasm was abundant and eosinophilic.The nuclear was round,oval,slightly atypia.lmmunohistochemical staining showed diffusely positive for CAM5.2,α-AT,α-ACT and focally positive for CA19-9,CEA,E-cad,β-cat and MUC-1 and only occasionally positive for AFP,NSE,Syn and CgA.Follow-up data showed there was one case of postoperative death due to postoperative pancreatic leakage with abdominal infection.Liver metastasis occurred in 4 cases,among whom,2 cases died.Conclusions Pancreatic acinar cell carcinoma is a rare epithelial malignant tumor of pancreas,with distinct phenotype characteristics.