Clinicopathological features of giant cell carcinoma of the pancreas.
BACKGROUND
Giant cell carcinoma of the pancreas (GCCP) as a tumor of high malignancy, large size, and inflammatory reaction occupies 2.1%-12.8% of all cases of pancreatic malignancies. This study was to analyze cases of GCCP collected in 8 years at our hospital in an attempt to describe some features of GCCP in Chinese people.


METHODS
The clinicopathological features of 19 patients who had been pathologically diagnosed as having GCCP from 1021 patients with pancreatic malignancies collected by Pancreatic Disease Research Group (PDRG) of Changhai Hospital were retrospectively analyzed compared with those of 96 patients with common pancreatic carcinoma (PC) who were randomly selected from 1002 patients with pancreatic carcinoma. The differences of location, clinical symptoms, imagings, laboratory test, operation and the prognosis of these two groups were defined.


RESULTS
Tumors in the head of the pancreas were found in 8 patients (42.1%), and those in the body or tail of the pancreas in 11 (57.9%). The initial symptom was abdominal pain in most patients (57.9%). Abdominal pain (73.7%), dyspepsia (63.2%), weight loss (36.8%) but jaundice were common at the time of diagnosis. The abnormal rates of routine laboratory tests in the GCCP group were lower than those in the common PC group. The assay of tumor markers between the groups of GCCP and common PC was approximately the same. The sensitivity and accuracy of ultrasonography, spiral computed tomography and magnetic resonance imaging were considerably high. Large carcinoma in stage IV was seen in 9 patients or 47.4% of the GCCP group, a rate higher than that in the common PC group. Osteoid formation was found microscopically in some patients, and poorly differentiated tumor cells were found in most patients. The 1-year survival rate was 17.6%, which was lower than that in the common PC group.


CONCLUSIONS
The clinicopathological features of GCCP are different from those of common PC. Imaging tests can be used together with the assay of tumor markers to diagnose GCCP as early as possible and to improve the prognosis of GCCP patients.
Zou
Xiao-Ping
XP
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. zxpfcp@yahoo.com.cn
Yu
Zhi-Liang
ZL
Li
Zhao-Shen
ZS
Zhou
Guo-Zhong
GZ
D000328:Adult; D000368:Aged; D018286:Carcinoma, Giant Cell / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis