Clinical characteristics and prognosis analysis of pancreatic acinar cell carcinoma
10.3760/cma.j.cn115396-20240311-00070
- VernacularTitle:胰腺腺泡细胞癌的临床特点及预后分析
- Author:
Aibaidula AILIXIER·
1
;
Liang MAO
;
Hao CHENG
;
Zhenghua CAI
;
Yudong QIU
Author Information
1. 南京大学医学院附属鼓楼医院胰腺与代谢外科，南京 210008
- Keywords:
Pancreatic neoplasms;
Acinar cell carcinoma;
Diagnosis;
Treatment;
Prognosis
- From:
International Journal of Surgery
2024;51(10):694-699
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics and prognosis of pancreatic acinar cell carcinoma (PACC).Methods:A retrospective case-control study analysis was conducted on the clinical data of 15 PACC patients admitted to Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School, Nanjing University from June 2010 to May 2023. The clinical features and prognosis were analyzed.Results:Among the 15 patients with PACC, there were 9 males and 6 females, with a median age of 56 years, age ranged from 34 to 78 years. Abdominal pain was the initial symptom in 80.0% (12/15) of patients. Only 3 patients had elevated serum alpha-fetoprotein or carbohydrate antigen 19-9 levels. 80.0% (12/15) of the tumors were located in the pancreatic head, with an mean maximum diameter was (5.85±3.27) cm. CT scans showed heterogeneous enhancement in all patients, with cystic changes observed in 10 patients′ tumors. 7 patients underwent surgical treatment, including 1 patient involving venous resection and 2 patients involving partial gastrectomy; postoperative staging revealed that stage IB in 3 patients, IIA in 3 patients, and stage Ⅲ in 1 patient. Immunohistochemistry showed that there were 5 cases of Syn (+ ), 3 cases of CgA (+ ), 2 cases of AFP (+ ), 7 cases of Trypsin (+ ), 2 cases of CK7 (+ ), 2 cases of CK19 (+ ), 7 cases of β-catenin (+ ) and 2 cases of CD56 (+ ). Treatment after surgery included adjuvant chemotherapy for all surgical patients. 4 patients received systemic therapy, while 4 patients did not receive any treatment. Follow-up was completed for 11 patients, and lost in 4 patients; among the 7 patients who underwent surgical resection, 3 patients died with an average survival time of 44 months, ranged from 24 to 74 months, while the remaining 4 patients were alive with an average follow-up time of 26 months, ranged from 14 to 38 months. Among the 4 patients treated with systemic therapy, the average survival time was 16 months, ranged from 2 to 41 months.Conclusions:PACC is a rare pancreatic tumor that mainly affects elderly men. Clinical symptoms are often atypical, and there are no specific serum markers. The characteristic imaging findings include uneven enhancement with cystic changes, and positivity for trypsin on immunohistochemistry. Surgical resection combined with adjuvant therapy can provide long-term survival for patients, while those with distant metastasis have a poorer prognosis.
