Advances in the study of postpancreatectomy acute pancreatitis / 中华外科杂志

Postpancreatectomy acute pancreatitis (PPAP) is an acute inflammation of the remnant pancreas in the early postoperative period caused by a variety of factors. With the progress of related research,PPAP has been confirmed as an independent risk factor for many severe complications such as postoperative pancreatic fistula. In some cases, it progresses to necrotizing PPAP, increasing the risk of mortality. Currently, the International Study Group for Pancreatic Surgery has standardized and graded PPAP as an independent complication, taking into account factors including serum amylase, radiological features, and clinical impact. This review summarizes how the concept of PPAP was proposed, as well as the latest progress in the research related to its etiology, prognosis, prevention, and treatment. However, given the large heterogeneity of relevant studies and the fact that they were mostly retrospective, in the future, it is necessary to place more emphasis on PPAP and elucidate the problems through more standardized studies to optimize strategies for the prevention and management of complications after pancreatic surgery.

Surgical treatment of non-functional pancreatic neuroendocrine neoplasms / 中国实用外科杂志

The incidence of non-functional pancreatic neuroendocrine neoplasms(NF-pNENs)constantly increases due to the development of imaging techniques and the popularity of routine medical examination.WHO classification system,ENETS and AJCC grading systems,widely used in clinical practice,are independent prognostic factors.According to the G grading system,NF-pNENs are classified into benign,low-grade malignant and high-grade malignant tumors.Operative indications and treatments are absolutely different for each subgroup.Lymph node metastasis closely correlates with the position and size of tumor,lymphovascular invasion and Ki-67 index.Pre-operative determination of the presence of lymph node metastasis provides significant instructions for the choice of surgery since it indicates early tumor relapse and metastasis.The advance of ultrasoundguide biopsy provides more sensitive indictors for preoperative pathological grade and lymph node metastasis.Both domestic and foreign guidelines consider the tumor size as the critical factors for surgery.For those NF-pNENs2 cm,even with local vascular and organs invasion,a routine pancreatic surgery is recommended(distal pancreatectomy or pancreatic duodenectomy according to the tumor position).Lymph node sampling or regional lymphadenectomy should be routinely performed during surgeries.For those with liver metastasis,surgical resection,locoregional ablative therapy or liver transplantation is suggested according to the situation of metastatic sites.

Diagnosis,treatment and etiology of hepatic infarction and abscess after pancreaticoduodenal surgery / 中国实用外科杂志

OBJECTIVE: To explore the causes and treatment of hepatic infarction and abscessafter pancreaticoduodenal surgery.METHODS: The clinical data of 11 cases of hepatic infarction or abscess after pancreaticoduodenal surgery in Peking Union Medical College Hospital between January 2012 and December 2018 were analyzed retrospectively.RESULTS: A total of 11 patients were diagnosed of hepatic infarction or abscess after PD.The overall mortality rate was27.3%(3 of 11 patients).54.5%(6/11)had biliary fistula.Of the 11 patients,7 had proper hepatic artery and right accessory hepatic artery occlusion or stenosis,1 had abdominal trunk root stenosis before operation,and 3 had PV stenosis.Enterococcus and Klebsiella were the organisms most frequently cultured,and fungi were also the common pathogens.Antibiotics and selective percutaneous drainage were the main means of treatment.CONCLUSION: Ischemia of hepatic artery and portal vein after PD is the main cause of liver infarction and liver abscess.Biliary fistula and multiple pathogenic bacteria are often associated with high mortality.

Visually Isoattenuating Pancreatic Acinar Cell Carcinoma:Report of One Case / 中国医学科学院学报

Acinar cell carcinoma of pancreas(ACCP)is a rare pancreatic exocrine tumor that accounts for about 1% of pancreatic tumors. The typical imaging manifestations of ACCP are as follows:(1)the tumor is large in volume,partially or completely exophytic;(2)complete or incomplete capsule is visible with thin linear enhancement;(3)CT density and MRI signal:plain CT images reveals that the tumors have similar or slightly hypodense densities relative to the adjacent normal pancreas,the solid part of ACCP has low to intermediate signal intensity on T1WI and intermediate to high signal intensity on T2WI compared with the surrounding normal pancreas;(4)pattern of enhancement:tumors exhibit heterogeneous enhancement and it is less than that in the surrounding normal pancreas;(5)fissure-like,swirling necrosis that may be a characteristic change of tumor;(6)pancreatic and biliary duct dilatation is rare;(7)adjacent organs and blood vessels around the pancreas may be invaded;(8)distant metastasis of liver and other parts may be observed;(9)PET-CT shows high FDG uptake. An ACCP patient with atypical imaging manifestations was treated in Peking Union Medical College Hospital from November 2015 to August 2017. The lesion manifested iso-enhancement and many imaging examinations failed to find the tumor. The patient ultimately underwent surgery and diagnosed as ACCP by pathology.

The role of perioperative enteral and parenteral nutrition treatment in pancreatic cancer: a multicenter, prospective randomized controlled trial / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the two different nutritional supports, enteral nutrition and parenteral nutrition in the aspects of nutritional conditions, immune status, the incidence of perioperative complications and quality of life impacts in pancreatic cancer.</p><p><b>METHODS</b>For the pancreatic cancer patients which pancreaticoduodenectomy were performed from January 2007 to December 2008 in five high-volume medical centres, prospective, randomized controlled study was carried out. The enrolled patients were randomly divided into enteral nutritional group (EN group) and parenteral nutritional group (PN group). Related indicators, such as nutritional conditions, immune status, incidence of complications, general status and quality of life were assessed.</p><p><b>RESULTS</b>The 200 patients were enrolled, while 178 cases which 90 patients in EN group and 88 patients in PN group were qualified to evaluate. The 22 cases were dropped out. For the mean hospital stay ((23 ± 13) days and (27 ± 24) days respcectively), Karnofsky score and the life quality scoring, there are no statistical differences between the two groups. In post-operation day 7 and day 10, the prealbumin was (69 ± 16) mg/L and (80 ± 22) mg/L in EN group and it was (67 ± 19) mg/L and (70 ± 11) mg/L in PN group, which are all significantly decreased than preoperational levels ((186 ± 38) mg/L for enteral group and (179 ± 37) mg/L for parenteral group, t = -2.24, -2.13, -2.23, -2.20, all P < 0.05), but there was no statistically significant between the 2 groups (P > 0.05). Other general indicators such as the albumin, hemoglobin, total bilirubin, blood urea nitrogen, serum creatinine, serum potassium and serum sodium, revealed no statistical differences in the 2 groups (P > 0.05); The total lymphocytes, CD(+)3CD(+)4 and CD(+)3CD(+)8 lymphocytes in PN group was (0.687 ± 0.065)×10(9)/L, (0.363 ± 0.029)×10(9)/L, and (0.183 ± 0.018)×10(9)/L respectively in post-operation day 10, which they are significantly decreased than in preoperational levels of PN group and the respective counterpart of EN group in post-operation day10 (t = -2.04-2.83, P < 0.05). The 35 patients were suffered from different complications in the 2 groups, but there was no statistical differences among them (P > 0.05).</p><p><b>CONCLUSIONS</b>Enteral nutritional support could not decrease the incidence of perioperative complications in pancreatic cancer patient, but it can improve the immunonutrition status in comparison with parenteral nutrition.</p>

Vitamin D status and the risk of pancreatic cancer: a meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Vitamin D status in relation to pancreatic cancer risks is still inconsistent. This study was performed to evaluate the association between vitamin D status and risk of pancreatic cancer using a meta-analysis approach.</p><p><b>METHODS</b>A systemic review of all relevant literature in English was performed by searching Pubmed, Web of Science and Embase to identify eligible studies from the earliest available date to April 1, 2012. The search terms "vitamin D", "25-hydroxyvitamin D", "pancreatic cancer" or "pancreatic neoplasms" were used to retrieve relevant papers. Inclusion criteria were: (1) the exposure of interest was intake of vitamin D or blood levels of vitamin D; (2) the outcome of interest was pancreatic cancer; (3) data on high and low intake or blood vitamin D in cases and controls were available; (4) odds ratio (OR) estimates with 95% confidence interval (CI) were provided; (5) primary epidemiological data were provided reporting pancreatic cancer incidence. The combined OR values and their 95% CIs were calculated via a meta-analysis. The potential presence of publication bias was estimated using Egger's regression asymmetry test.</p><p><b>RESULTS</b>Nine studies with a total of 1 206 011 participants met the inclusion criteria. The test for heterogeneity showed there were significant differences among the included studies (I(2)=70.9%, P=0.001), so a randomized-effects model was used in the meta-analysis. The pooled OR of pancreatic cancer for the highest versus the lowest categories of vitamin D level was 1.14 (95% CI 0.896-1.451), and the Z-score for the overall effect was 1.06 (P=0.288), showing that there was no significant association between vitamin D levels and the risk of pancreatic cancer. Egger's test indicated there was a low possibility of publication bias in this study (P=0.348).</p><p><b>CONCLUSION</b>Dietary vitamin D or circulating concentrations of 25-hydroxyvitamin D are not associated with the risk of pancreatic cancer based on evidence from currently published studies.</p>

Umbilical hernia repair in conjunction with abdominoplasty / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and clinical benefits of umbilical hernia repair in conjunction with abdominoplasty.</p><p><b>METHODS</b>The incision was designed in accord with abdominoplasty. The skin and subcutaneous tissue was dissected toward the costal arch, and then the anterior sheath of rectus abdominus was exposed. After exposure and dissection of the sac of umbilical hernia, tension-free hernioplasty was performed with polypropylene mesh. After dissecting the redundant skin and subcutaneous tissue, the abdominal wall was tightened.</p><p><b>RESULTS</b>Between May 2008 and May 2011, ten patients were treated in the way mentioned above. The repair of umbilical hernia and the correction of abdominal wall laxity were satisfactory. There was no recurrence of umbilical hernia, hematoma, seroma or fat liquefaction.</p><p><b>CONCLUSION</b>Through careful selection of patients, repair of umbilical hernia and body contouring could be achieved simultaneously.</p>

Surgical treatment strategy for malignant pancreatic neuroendocrine tumor / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the surgical options for the malignant pancreatic neuroendocrine tumor (PNETs).</p><p><b>METHODS</b>The clinic data of 32 patients with malignant pancreatic neuroendocrine tumors who were admitted between January 2003 and December 2009 were summarized. There were 19 male and 13 female, aging from 17 to 71 years (mean age, 46.3 years). The general information, postoperative pathology results, surgical options and followup were also collected.</p><p><b>RESULTS</b>There were 32 cases of malignant PNETs including functional malignant PNETs in 12 cases and nonfunctional malignant PNETs in 20 cases. Thirty-one patients accepted surgical treatments which included local resections in 4 patients, Whipple procedures in 7 patients, distal pancreatectomy in 17 patients and laparotomy in 3 patients. One patient accepted CT guided biopsy. Follow up were lost in two patients after operations. Five patients died in the first year after operations. Twenty-two patients still survived after mean follow up of 28 months (4 - 83 months). The survival rate for this group of patients was 83.5% in the first year, 72.6% in the second year and 54.4% in the fifth year.</p><p><b>CONCLUSIONS</b>Malignant PNETs is the proper indication for surgical treatments. More accumulation of clinical data is needed to evaluate the significance of local resection of malignant PNETs in pancreatic head and cytoreductive surgery.</p>

Evaluation of RCAS1 as serum tumor marker for pancreatic cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of receptor-binding cancer antigen expressed on SiSO cells (RCAS1) as serum tumor marker on the diagnosis of pancreatic cancer.</p><p><b>METHODS</b>Receiver-operating characteristics (ROC) curve methods were used to assay the serum content of RCAS1, CA19-9 and CA242 in 46 patients with pancreatic cancer, 18 patients and 20 normal tissues of chronic pancreatitis detected by enzyme linked immunosorbent assay (ELISA), and the results were analyzed by statistics methods. The expressions of RCAS1 protein were analyzed by immunohistochemical method in 32 patients with pancreatic cancer, 10 patients with chronic pancreatitis and 6 cases of normal pancreatic specimens.</p><p><b>RESULTS</b>The serum levels of RCAS1, CA19-9 and CA242 in pancreatic cancer were higher than that in chronic pancreatitis respectively (P < 0.01). The area under curve of RCAS1, CA19-9 and CA242 were 0.826, 0.804 and 0.737, respectively. Subgroup analysis indicated that the RCAS1 and CA19-9 levels of pancreatic cancer patients without obstructive jaundice were lower than those for patients with obstructive jaundice (P < 0.01). CA19-9 levels of patients with resectable pancreatic cancer were lower than those with unresectable pancreatic cancer (P < 0.01). Immunohistochemistry showed that the expression rates of RCAS1 in pancreatic cancer and chronic pancreatitis were 87.5% and 40.0%, respectively (P < 0.05).</p><p><b>CONCLUSIONS</b>In diagnosis of pancreatic cancer, the clinical value of RCAS1 is available. And the combination test of RCAS1 and CA19-9 have clinical value to evaluate if the pancreatic cancer can be resected before operation.</p>

Noninvasive examinations for localization of insulinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the value of the noninvasive examinations for localization of insulinoma.</p><p><b>METHODS</b>The clinical materials of 88 cases of insulinoma treated in Peking Union Medical College Hospital between January 2005 and November 2008 were analyzed retrospectively. There were 40 males and 48 females aged from 15 to 74 years old (averaged, 46.5 years old).</p><p><b>RESULTS</b>The positive rates for localization were 19.3% (17/88), 52.4% (11/21), 95.5% (64/67), 1/6, 30.0% (6/20), 83.9% (26/31), 8/8 and 5/5 respectively in transabdominal ultrasound, enhanced CT, multislice spiral CT pancreatic perfusion, MRI, somatostatin receptor scintigraphy, endoscopic ultrasound, laparoscopic ultrasound and intraoperative ultrasound. Thirty-one multiple tumors in 8 patients were resected. The positive rates of locating the multiple insulinomas of multislice spiral CT pancreatic perfusion and Intraoperative Ultrasound were 48.4% (15/31) and 100% (14/14) respectively.</p><p><b>CONCLUSIONS</b>The locating diagnosis of insulinoma has came to noninvasive examination era. Multislice spiral CT pancreatic perfusion is the first choice for localization. Intraoperative ultrasound might play an important role in locating tumors for patients with multiple insulinomas.</p>

Clinical study of the improvement gastrostomy in pancreaticoduodenectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the clinical significance of improvement gastrostomy in pancreaticoduodenectomy.</p><p><b>METHODS</b>Clinical data of 82 patients who underwent pancreaticoduodenectomy and jejunostomy from November 2004 to December 2006 were collected, among which 36 patients received improvement gastrostomy (treatment group), 24 patients accepted traditionary gastrostomy (control group 1) and 22 patients without any gastrostomy (control group 2). Operative time, postoperative duration of gastrointestinal decompression tube, postoperative gastroparesis, pancreatic fistula, biliary fistula, and abdominal cavity infection were compared.</p><p><b>RESULTS</b>The incidence of postoperative gastroparesis in the treatment group and control group 2 were can significantly lower than that in the control group 1 (P < 0.05). The postoperative duration of gastrointestinal decompression tube of the treatment group was significant shorter than that of control group 2 (P < 0.01). There were no significant difference in other items.</p><p><b>CONCLUSIONS</b>The improvement gastrostomy in pancreaticoduodenectomy is simple and secure. It can significantly shorten the postoperative duration of gastrointestinal decompression tube and also obviously reduce the incidence of postoperative gastroparesis compared with traditionary gastrostomy.</p>

The relationship between the changes of proangiogenic factors serum concentrations and progression of pancreatic carcinoma patients / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between VEGF, bFGF and IGF-1 serum concentration and progression of pancreatic carcinoma.</p><p><b>METHODS</b>Fifty-six patients with pancreatic carcinoma were divided into resectable group (n = 32) and unresectable group (n = 24). Another group was normal group (n = 20). The expression and significance of these proangiogenic factors were respectively analyzed in different groups.</p><p><b>RESULTS</b>For pancreatic carcinoma group, concentrations of VEGF and bFGF were significantly higher than these of normal group (P < 0.01). Serum VEGF was significantly correlated with the resection of pancreatic carcinoma (P < 0.05) while bFGF and IGF were not. According to univariate analysis, serum VEGF was correlated with tumor grade, nodal disease, vascular invasion, distant metastases and tumor stage. Serum bFGF was associated with tumor size and grade. Serum IGF-1 was correlated with vascular invasion.</p><p><b>CONCLUSIONS</b>Angiogenic factors play important roles in growth, invasion and metastasis. Detection of serum proangiogenic factors may have potential value in diagnosis and prognosis of pancreatic carcinoma.</p>

Relationship between changes of serum concentrations of antiangiogenic factors and disease progression in patients of pancreatic carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between TSP-1, Angiostatin and Endostatin serum concentrations and progression of pancreatic adenocarcinoma.</p><p><b>METHODS</b>Fifty-six patients with suspected pancreatic cancer were enrolled in the study and divided into resectable group (n = 32) and unresectable group (n = 24) according to evaluation and staging with dual phase helical CT. Histopathologic examinations included postoperative final pathology and preoperative fine needle biopsies. Peripheral blood concentrations of antiangiogenic factors Angiostatin, Endostatin and TSP-1 were detected by using ELISA methods, selecting samples of health people as a control.</p><p><b>RESULTS</b>Serum concentrations of antiangiogenic factors in pancreatic cancer group were significantly higher than those in health group (P < 0.01). Serum concentrations of Endostatin, Angiostatin and TSP-1 were significantly increased in unresectable group, and highly expressed in patients whom tumor sizes were greater than 2 cm and tumor invaded peripancreatic great vessels (P < 0.05). After operation, serum concentrations of Endostatin, Angiostatin and TSP-1 significantly decreased (P < 0.05). There were no significant difference between I, II stage group and III, IV group.</p><p><b>CONCLUSIONS</b>Detection of serum concentrations of antiangiogenic factors may be used to evaluate the resectability of pancreatic cancer and may play important roles in growth, invasion and metastasis of pancreatic cancer.</p>

Laparoscopic distal pancreatectomy: current indications and surgical results / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety, feasibility indications, prognosis and follow-up of laparoscopic distal pancreatectomy.</p><p><b>METHODS</b>Retrospective study was employed on 10 patients collected from Feb. to Oct. 2005 with diagnosis of masses located at pancreatic body/tail. The mean age was 43 years and ratio between male and female was 1:9. Preoperative diagnosis: nine patients with cystic lesion located at pancreatic body and tail, one patient with pancreatic endocrine tumor with liver metastasis, which located at pancreatic tail. The mean size of the tumor was 4.0 cm. All patients received adjuvant examinations including CT contrast scan, abdominal ultrasound or endoscopic ultrasound. The serum levels of tumor markers (including CA19-9, CA242, CA50 and CEA) of the patients were all normal.</p><p><b>RESULTS</b>All patients received distal pancreatectomy by laparoscope successfully. Among them, seven procedures were spleen-preserved and three with splenectomy. Mean operative time was 228 +/- 26 min, and mean blood lose volume was 173 +/- 100 ml. One patient suffered with pancreatic fistula after operation but was successfully managed by conservative therapy in one month, pancreatic pseudocyst was detected in one patient and disappeared spontaneously in one month, no other morbidity occurred. The postoperative hospital stay was 12 - 16 d (mean, 13.5 d). The serum glucoses of 10 patients after operation were normal. The mean time of follow-up was 8 months (2 - 22 months). During the follow-up, nine patients with benign cystic lesions did not relapse. And the other one patient with malignant metastasis kept stable, not recurrence was detected in one year after operation.</p><p><b>CONCLUSIONS</b>Laparoscopic distal pancreatectomy was safe and feasible for benign cystic tumors located at the body or tail of the pancreas.</p>

Surgical treatment of pancreatic insulinoma by laparoscopy / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and outcome of laparoscopic insulinoma resection.</p><p><b>METHODS</b>Twenty-five patients with insulinoma were admitted and divided into two groups: laparoscopic group (10 patients) and laparotomy group (15 patients). All tumors of two groups were located at the body or tail of pancreas preoperatively by abdominal CT and digital subtraction angiography (DSA). Laparoscopic enucleation was performed for patients in laparoscopic group, open enucleation was performed for patients in laparotomy group. There were no differences in preoperative location and size of tumors between two groups. Statistical method was used to compare the discrepancy from operation time, the volume of blood loss, hospital stay and morbidity of complication between two groups.</p><p><b>RESULTS</b>There were no discrepancies from operation time, blood loss, hospital stay after operation between two groups (P > 0.05). However, one case of pancreatic leakage developed in laparoscopic group, comparably, 3 cases of pancreatic leakage, 2 cases of celiac sepsis and 5 cases of fluid accumulation in thoracic cavity developed in laparotomy group. There were significant discrepancies in morbidity of complication between two groups.</p><p><b>CONCLUSIONS</b>Laparoscopic resection of pancreatic insulinoma is safe and feasible for tumors located at the body or tail of the pancreas. Its application for tumors located at the pancreatic head needs further evaluation.</p>

Anti-pancreatic cancer effects of human peripheral gammadeltaT cells in a mouse tumor model / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the adoptive immunotherapy effect of peripheral gammadeltaT cells in pancreatic cancer nude mice model.</p><p><b>METHODS</b>Thirty BALB/c nude mice were inoculated subcutaneously 5 x 10(5) Cap-1 cells to regularly developed hypodermal tumors, and then divided into 3 groups randomly, gammadeltaT cells, alphabetaT cells and control group. 2.5 x 10(6) gammadeltaT cells or alphabetaT cells or 100 microl RPMI-1640 were respectively injected into abdominal cavity of mice, combined with 10(4) U rhIL-2 for 3 times. Tumor volume, the survival rate and anti-carcinogenic rate of three groups were compared.</p><p><b>RESULTS</b>Eight control nude mice developed hypodermal tumors, which progressively increased in size, and animals had a mean survival of 88 d. Nine nude mice in gammadeltaT cells group and eight in alphabetaT cells group developed tumors (P > 0.05). Tumor growth was arrested and tumor size was reduced remarkably in gammadeltaT cells group. Mean survival was increased to 113 d with less rate of tumor metastasis and more cases of tumor necrosis in gammadeltaT cells group when compared with alphabetaT cells group and controls.</p><p><b>CONCLUSIONS</b>The anti-tumor effects of gammadeltaT cells against pancreatic cancer are better than those of alphabetaT cells and control groups, and might be promising in the adoptive immunotherapy of pancreatic cancer.</p>

Perioperative nutrition support of the patients with pancreatic head cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the effect of perioperative nutrition support on nutritional condition and complications of the patients with postoperative pancreatic head cancer.</p><p><b>METHODS</b>Thirty four patients received perioperative nutrition support, including enteral nutrition and parenteral nutrition (treatment group). Forty eight patients received routine postoperative parenteral nutrition (control group). According to the operative method, these two groups were further divided into two sub-groups: (1) pancreaticoduodenectomy (PD) subgroup, including 13 cases from treatment group, and 24 cases from control group; (2) palliative operation subgroup, including 21 cases from treatment group, and 24 cases from control group. Body weight, total protein (TP), serum albumin (ALB), and the complications after operation were compared.</p><p><b>RESULTS</b>The concentrations of ALB and TP in the treatment group were significantly higher than those in the control group (P< 0.05). Body weight and TP of the patients received PD in the treatment group were significantly better than those of the control group (P < 0.05).</p><p><b>CONCLUSION</b>Perioperative nutrition support can improve postoperative nutritional condition and reduce the postoperative complications in patients with pancreatic head cancer.</p>

Diagnosis and treatment of pancreatic serous cystadenoma / 中国医学科学院学报

<p><b>OBJECTIVE</b>To summarize our experience on the diagnosis and treatment of pancreatic serous cystadenoma.</p><p><b>METHOD</b>Data from 20 patients with pancreatic serous cystadenoma in Peking Union Medical College Hospital from 1994 to 2004 were analyzed retrospectively.</p><p><b>RESULTS</b>Ultrasound test was a good choice for primary diagnosis, while computed tomography scan and endoscopic retrograde cholangiopancreatography (ERCP) were better choice for the suspected cases. Most tumors (60%) were located in the body and tail of pancreas. The distal pancreatectomy was the commonest operation procedure. The main complications were pancreatic leakage (35%). The symptoms were resolved after surgical treatment.</p><p><b>CONCLUSIONS</b>The treatment of pancreatic serous cystadenoma depends on the accurate diagnosis. Ultrasound and computed tomography are useful diagnostic methods. Surgical operation is the treatment of choice. Long-term follow-up has shown satisfactory outcomes if the tumors are resected completely.</p>

The diagnosis and treatment of solid-pseudopapillary tumor of pancreas / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the experience of diagnosis and treatment in solid-pseudopapillary tumor of pancreas (SPT).</p><p><b>METHOD</b>Retrospectively analyzed 12 cases of SPT diagnosed between 2000 August and 2004 February in Peking Union Medical College Hospital.</p><p><b>RESULTS</b>The average age of these 12 cases was 29.1, including 11 women and 1 men. The tumors of 6 cases were located in the pancreatic head, one tumor was in the neck of pancreas and 5 tumors were in the body and tail of pancreas. There were no characteristic clinical manifestations. Solid and solid-cystic masses of low echo were found in pancreas in ultrasonic examinations. CT scan found masses of low density in pancreas, while irregular enhancement appeared in the circumference of all tumors in enhanced CT scan sequences. Tumor markers in patients' serum were all negative. Pancreaticoduodenectomy were performed in 2 cases. Resection of tumors and pancreaticojejunostomy were performed in 3 cases. Simple resection of tumor was performed in 1 case. Segmental pancreatectomy and pancreaticojejunostomy was performed in one patient. Five patients underwent distal pancreatectomy and spleen resection. Ten patients were followed up with the average time of 14.3 months. No evidence of relapses and metastasis in these cases was found.</p><p><b>CONCLUSION</b>Solid-pseudopapillary tumor of pancreas was one of rare pancreatic neoplasm with low malignant potential, affecting primarily young women. Complete resection resulted in long-term survival.</p>

Cytotoxicity of MICA-reactive V delta 1 gamma delta T cells towards epithelial tumor cells / 中国医学科学院学报

<p><b>OBJECTIVE</b>To confirm whether human MHC class I chain-related A (MICA) induces the amplification of V delta 1 gamma delta tumor-infiltrating lymphocytes (TILs) in vitro and to identify the cytotoxicity of MICA-reactive V delta 1 gamma delta TILs towards epithelial tumor cells.</p><p><b>METHODS</b>MICA protein was prokaryoticly expressed and purified by molecular cloning technology. The purified recombined MICA (rMICA) was used to induce V delta 1 gamma delta T cells from tumor tissues in vitro and the cytotoxicity of these V delta 1 gamma delta TILs were tested by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT).</p><p><b>RESULTS</b>The rMICA was expressed in prokaryocyte with pET30 as a vector. The immobilized rMICA protein could markedly induce the amplification of V delta 1 gamma delta T cells from tumor tissue in vitro. These V delta 1 gamma delta T cells showed strong cytolytic activities towards tumor cell lines expressing MICA.</p><p><b>CONCLUSION</b>The MICA-reactive V delta 1 gamma delta T cell may be a candidate for adoptive cellular therapy of tumors.</p>