Pre-Operative Imaging and Pathological Diagnosis of Localized High-Grade Pancreatic Intra-Epithelial Neoplasia without Invasive Carcinoma.
Pre-Operative Imaging and Pathological Diagnosis of Localized High-Grade Pancreatic Intra-Epithelial Neoplasia without Invasive Carcinoma.
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DOI：
10.3390/cancers13050945
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发表时间：
2021-02-24
期刊：
影响因子：
5.2
通讯作者：
Amano Y
中科院分区：
文献类型：
--
作者：
Sagami R;Yamao K;Nakahodo J;Minami R;Tsurusaki M;Murakami K;Amano Y
胰腺导管腺癌(PDAC)通常预后极差，但小的PDAC肿瘤预后良好。高级别胰腺上皮内瘤变(Panin)先于侵袭性PDAC，是改善PDAC预后的主要目标。然而，用现有的成像手段检测没有浸润性癌的高级别Panin是困难的，因为病变只能在显微镜下检测到。最近的研究报道了与局限性高级别Panin相关的影像表现特征，以及胰液连续抽吸细胞学检查作为确认术前组织病理学的有用方法。在这篇综述中，我们旨在阐明最近关于检测到局部高级别Panin的临床结果，这可能有助于改善PDAC患者的预后。胰腺导管腺癌(PDAC)起源于胰腺上皮内瘤变(Panin)和导管内乳头状黏液瘤(IPMN)等前驱病变。高级别癌前病变，包括高级别Panin和高级别IPMN，没有浸润性癌，预后良好，尽管PDAC总体预后较差。因此，高级别Panin作为侵袭性PDAC之前的病变，是介入治疗的主要靶点。然而，当使用标准的放射学方法时，很难检测到局限性的高级别Panin。因此，大多数对高级别Panin的研究都是使用含有侵袭性PDAC的标本进行的。最近，高品级Panin的成像特征被揭示出来。高级别Panin引起的胰管梗阻可能会导致腺泡细胞丢失，代之以纤维化和小叶实质萎缩。这些改变和分支胰管(BPD)周围的额外炎症导致主胰管(MPD)狭窄、扩张、滞留囊肿(BPD扩张)、局灶性胰腺实质萎缩和/或MPD周围的低回声改变。这些间接的影像表现已成为定位、高级别Panin检测的重要线索。为使疑似病例获得术前病理证实，胰液连续抽吸细胞学检查是有效的。在这篇综述中，我们概述了目前对高级别Panin的成像特征的认识。
Pancreatic ductal adenocarcinoma (PDAC) is typically associated with an extremely poor prognosis; however, small PDAC tumors show good prognosis. High-grade pancreatic intra-epithelial neoplasia (PanIN), which precedes invasive PDAC, is a primary target for improving the prognosis of PDAC. However, detection of high-grade PanIN without invasive carcinoma by existing imaging modalities is difficult because the lesions are only microscopically detectable. Recent studies have reported the characteristics of imaging findings associated with localized high-grade PanIN and the usefulness of serial pancreatic-juice aspiration cytologic examination as a method to confirm the pre-operative histopathology. In this review, we aimed to clarify recent clinical findings regarding detection of localized high-grade PanIN, which may contribute to improvement of the prognosis of patients with PDAC. Pancreatic ductal adenocarcinoma (PDAC) arises from precursor lesions, such as pancreatic intra-epithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasm (IPMN). The prognosis of high-grade precancerous lesions, including high-grade PanIN and high-grade IPMN, without invasive carcinoma is good, despite the overall poor prognosis of PDAC. High-grade PanIN, as a lesion preceding invasive PDAC, is therefore a primary target for intervention. However, detection of localized high-grade PanIN is difficult when using standard radiological approaches. Therefore, most studies of high-grade PanIN have been conducted using specimens that harbor invasive PDAC. Recently, imaging characteristics of high-grade PanIN have been revealed. Obstruction of the pancreatic duct due to high-grade PanIN may induce a loss of acinar cells replaced by fibrosis and lobular parenchymal atrophy. These changes and additional inflammation around the branch pancreatic ducts (BPDs) result in main pancreatic duct (MPD) stenosis, dilation, retention cysts (BPD dilation), focal pancreatic parenchymal atrophy, and/or hypoechoic changes around the MPD. These indirect imaging findings have become important clues for localized, high-grade PanIN detection. To obtain pre-operative histopathological confirmation of suspected cases, serial pancreatic-juice aspiration cytologic examination is effective. In this review, we outline current knowledge on imaging characteristics of high-grade PanIN.
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影响因子：
7.5
作者：
Detlefsen, Soenke;Sipos, Bence;Kloeppel, Guenter
通讯作者：
Kloeppel, Guenter
影响因子：
5
作者：
Choi, Jin-Young;Kim, Myeong-Jin;Yoo, Hyung Sik
通讯作者：
Yoo, Hyung Sik
DOI：
10.1097/pas.0000000000000533
发表时间：
2015-12
期刊：
The American journal of surgical pathology
影响因子：
--
作者：
Basturk O;Hong SM;Wood LD;Adsay NV;Albores-Saavedra J;Biankin AV;Brosens LA;Fukushima N;Goggins M;Hruban RH;Kato Y;Klimstra DS;Klöppel G;Krasinskas A;Longnecker DS;Matthaei H;Offerhaus GJ;Shimizu M;Takaori K;Terris B;Yachida S;Esposito I;Furukawa T;Baltimore Consensus Meeting
通讯作者：
Baltimore Consensus Meeting
影响因子：
7.5
作者：
Furukawa, T;Fujisaki, R;Horii, A
通讯作者：
Horii, A
影响因子：
3.6
作者：
Chen, Ge;Liu, Shanglong;Zhang, Taiping
通讯作者：
Zhang, Taiping