Background:Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor with malignant potential. Its diagnosis has grown alongside increased use of abdominal imaging. SPN is suspected after classical findings in abdominal imaging studies; however, endoscopic ultrasound-guided (EUS) fine needle aspiration can support preoperative diagnosis. The treatment of choice is still surgical intervention, with an intent to reach curative resection. The prognosis is excellent. Recently, emerging data on EUS-guided radiofrequency ablation (RFA) suggest changing the choice of treatment for small SPN.Methods:We provide a comprehensive overview on pancreatic SPN with a focus on treatment, adverse events, recurrence rate, and outcomes. In addition, we provide a literature summary and pool data analysis.Results:Overall, 70 papers including 6651 patients were identified. The mean SPN size was 5.8 cm, metastasis rate was 1.9%, and recurrence rate was 3%. Moreover, the mortality rate was low at 0.2%, although high postoperative adverse events were reported (32.4%). Small SPN (<2 cm) was present in 4.1% of the studies. Two studies reported EUS-RFA for small SPN <2 cm, without recurrence at a median follow-up of 18.5 months.Conclusions:SPN still necessitates surgical intervention given its malignant potential. However, EUS-RFA can represent a promising and safe therapeutic option for SPN < 2 cm.
背景：实性假乳头状瘤（SPN）是一种具有恶性潜能的罕见胰腺肿瘤。随着腹部影像学检查的广泛应用，其诊断率逐渐提高。腹部影像学检查发现典型表现后需怀疑SPN，而内镜超声引导下细针穿刺活检可支持术前诊断。目前首选治疗方式仍为外科手术干预，旨在实现根治性切除，患者预后良好。近期关于内镜超声引导下射频消融治疗的研究数据表明，对于小型SPN的治疗选择正在发生变化。 方法：本文系统综述胰腺SPN的治疗现状，重点关注治疗方式、不良事件、复发率及临床结局，并进行文献总结与数据整合分析。 结果：共纳入70篇文献，涉及6651例患者。SPN平均直径为5.8厘米，转移率为1.9%，复发率为3%。尽管术后不良事件发生率较高（32.4%），但死亡率较低（0.2%）。4.1%的研究涉及小型SPN（<2厘米）。两项研究报道了内镜超声引导下射频消融治疗直径<2厘米的小型SPN，中位随访18.5个月均未出现复发。 结论：鉴于SPN的恶性潜能，目前仍需外科手术干预。但对于直径小于2厘米的SPN，内镜超声引导下射频消融可能成为具有前景且安全的治疗选择。
肿瘤(癌症)患者之家