Natural History of Branch Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas A Multicenter Study in Japan
Natural History of Branch Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas A Multicenter Study in Japan
复制标题
DOI：
10.1097/mpa.0b013e31820a5975
复制
发表时间：
2011-04-01
期刊：
影响因子：
2.9
通讯作者：
Tanaka, Masao
中科院分区：
文献类型：
--
作者：
Maguchi, Hiroyuki;Tanno, Satoshi;Tanaka, Masao
目的：本研究的目的是评估日本10个代表性机构无壁结节（MNs）分支导管内乳头状粘液瘤（BD-IPMNs）患者的长期随访结果。方法：对349例初诊时超声内镜检查无MNs的BD-IPMN患者进行随访分析。结果：观察期1 ~ 16.3年（中位3.7年）。62例（17.8%）患者在随访期间出现疾病进展。22例接受手术，病理诊断为癌9例，腺瘤13例。其余287例（82.2%）无变化，其中7例因症状（n = 2）、选择（n = 2）或发生胰管腺癌（n = 3）而行手术；病理诊断均为腺瘤。在29例接受手术的患者中，所有9例癌患者均表现出进展迹象，如主胰管直径增加和/或出现MNs。7例（2.0%）和13例（3.7%）分别发生胰腺导管腺癌和其他BD-IPMNs。总体而言，320例（91.7%）患者无手术随访。结论：大多数超声内镜检查未发现MNs的BD-IPMN患者无需手术治疗。然而，在随访期间应注意疾病进展和胰腺导管腺癌的发展。
Objective: The aim of this study was to evaluate the long-term follow-up results of patients with branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) without mural nodules (MNs) at 10 representative institutions in Japan.Methods: We analyzed 349 follow-up BD-IPMN patients who had no MNs on endoscopic ultrasonography at initial diagnosis.Results: Observation periods ranged from 1 to 16.3 years (median, 3.7 years). Sixty-two (17.8%) patients exhibited disease progression during follow-up. Twenty-two underwent surgery, leading to a pathological diagnosis of carcinoma in 9 and adenoma in 13. Although the remaining 287 (82.2%) showed no changes, 7 underwent surgery because of symptoms (n = 2), choice (n = 2), or development of pancreatic ductal adenocarcinoma (n = 3); all of them were diagnosed pathologically as adenomas. Of the 29 patients undergoing surgery, all 9 with carcinoma exhibited signs of progression, such as increased main pancreatic duct diameter and/or appearance of MNs. Pancreatic ductal adenocarcinomas and additional BD-IPMNs developed in 7 (2.0%) and 13 (3.7%), respectively. Overall, 320 (91.7%) patients were followed without surgery.Conclusions: Most BD-IPMN patients who had no MNs on endoscopic ultrasonography could be managed without surgery. However, careful attention should be paid to disease progression and the development of pancreatic ductal adenocarcinomas during follow-up.