Prognosis of invasive intraductal papillary mucinous neoplasms of the pancreas.
Prognosis of invasive intraductal papillary mucinous neoplasms of the pancreas.
复制标题
胰腺侵袭性导管内乳头状粘液性肿瘤的预后。
DOI：
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发表时间：
2010
影响因子：
2
通讯作者：
P. Allen
中科院分区：
文献类型：
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作者：
A. Yopp;P. Allen
导管内乳头状粘液性肿瘤（IPMN）是胰腺产生粘液的囊性肿瘤，在组织学上分为非侵入性和侵入性成分。在切除的IPMN病变中，非浸润性和相关浸润性癌的5年生存率分别为90%和40%。IPMN病变内的浸润性癌可根据组织学亚型进一步分为胶质癌和管状癌。胶质癌切除后的估计5年生存率范围为57%-83%，管状癌切除后的估计5年生存率范围为24%-55%。侵袭性胶体型和管状型IPMN之间的生存结果差异似乎是疾病生物学的功能，因为管状亚型患者往往具有较大的肿瘤，并有转移到区域淋巴结的倾向。根据纪念斯隆-凯特琳癌症中心胰腺癌诺模图，与切除的常规胰腺癌病变匹配时，胶质癌组织学亚型与常规胰腺癌相比，估计5年生存率分别为87%和23%（P = 0.0001）。与传统胰腺癌相比，管状癌亚型的切除病变总体上具有相似的5年生存结局。然而，当这些组按区域淋巴结状态分层时，区域淋巴结阴性和管状亚型的患者的生存率明显高于类似淋巴结状态和导管腺癌的患者，估计5年生存率分别为73%和27%（P = 0.01）。
Intraductal papillary mucinous neoplasms (IPMN) are mucin producing cystic neoplasms of the pancreas histologically classified as having non-invasive and invasive components. The five-year survival rates for non-invasive and associated invasive carcinoma are 90% and 40%, respectively in resected IPMN lesions. Invasive carcinoma within IPMN lesions can be further classified by histological subtype into colloid carcinoma and tubular carcinoma. Estimated five-year survival rates following resection of colloid carcinoma range from 57%-83% and estimated five-year survival following resection of tubular carcinoma range from 24%-55%. The difference in survival outcome between invasive colloid and tubular IPMN appears to be a function of disease biology, as patients with the tubular subtype tend to have larger tumors with a propensity for metastasis to regional lymph nodes. When matched to resected conventional pancreatic adenocarcinoma lesions by the Memorial Sloan Kettering Cancer Center pancreatic adenocarcinoma nomogram, the colloid carcinoma histological subtype has an improved estimated five-year survival outcome compared to conventional pancreatic adenocarcinoma, 87% and 23% (P = 0.0001), respectively. Resected lesions with the tubular carcinoma subtype overall have a similar five-year survival outcome compared to conventional pancreatic adenocarcinoma. However, when these groups were stratified by regional lymph node status patients with negative regional lymph nodes and the tubular subtype experienced significantly better survival than patients with a similar nodal status and ductal adenocarcinoma with estimated five-year survival rates of 73% and 27% (P = 0.01), respectively.