Mucin-producing neoplasms of the pancreas. Intraductal papillary and mucinous cystic neoplasms.
Mucin-producing neoplasms of the pancreas. Intraductal papillary and mucinous cystic neoplasms.
复制标题
胰腺产生粘蛋白的肿瘤。
DOI：
10.1097/00000658-199602000-00005
复制
发表时间：
1996
影响因子：
9
通讯作者：
W. Lui
中科院分区：
文献类型：
--
作者：
Y. Shyr;C. Su;S. Tsay;W. Lui
目的
作者比较了胰腺导管内乳头状和粘液性囊性肿瘤的临床病理特征，阐明了这两种肿瘤之间的相似性和差异性。此外，他们回顾了104例导管内乳头状肿瘤的英文文献，以提供一个全面的看法的条件。
背景数据摘要
关于胰腺导管内乳头状肿瘤的术语和临床病理实体仍存在争议。目前，只有少数情况下，这种罕见的肿瘤在每个报告，仍然有足够的知识，关于肿瘤和方法，以区分它的粘液性囊性肿瘤。
方法
我们比较了台北荣民总医院医学中心1985年至1994年间所发现的导管内乳头状与黏液性囊性肿瘤的人口统计学与临床病理学参数。
结果
导管内乳头状腺癌4例，粘液性囊性肿瘤10例（囊腺癌8例，囊腺瘤2例）。两组患者的性别、年龄、肿瘤大小、肿瘤部位及病理结果均存在差异。导管内乳头状腺癌的临床表现与壶腹周围肿瘤相似。粘液性囊性肿瘤最常见的临床表现是上腹痛和腹部肿块。内镜逆行胰胆管造影（ERCP）显示，所有4例导管内乳头状腺癌均显示从扩张的乏特壶腹开口处分泌粘液，扩张的主胰管充盈缺损。准确的术前诊断是不容易的两组。血清糖链抗原19-9（CA 19-9）对两组的诊断更有价值。
结论
导管内乳头状肿瘤是一种独特的临床实体，但在性别、年龄、大小、肿瘤位置或病理图片方面不是粘液性囊性肿瘤的变体。ERCP的特征性表现有助于诊断。对于这两种低度恶性的粘液瘤，应尝试非常积极的外科手术。
OBJECTIVE
The authors compared the clinicopathologic features of the intraductal papillary and mucinous cystic neoplasms of the pancreas and clarified the similarities as well as the differences between these two tumors. In addition, they reviewed 104 cases of the intraductal papillary neoplasm in the English literature to provide a global view of the condition.
SUMMARY BACKGROUND DATA
Controversy about the term and clinicopathologic entity still exist regarding intraductal papillary neoplasm of the pancreas. Currently, with only a few cases of this rare tumor in each report, there continues to be inadequate knowledge available regarding the tumor and methods by which to distinguish it from the mucinous cystic neoplasm.
METHODS
Multiple demographic and clinicopathologic parameters were compared between intraductal papillary and mucinous cystic neoplasms identified from 1985 to 1994 in the Medical Center, Veterans General Hospital--Taipei.
RESULTS
There were four intraductal papillary adenocarcinomas and 10 mucinous cystic neoplasms (8 cystadenocarcinoma and 2 cystadenoma). The sex, age, size, tumor location, and pathologic findings were quite different between these two groups. Clinical presentation of intraductal papillary adenocarcinomas were similar to those of periampullary tumors. The most common presentations of mucinous cystic neoplasm were epigastric pain and abdominal mass. All four intraductal papillary adenocarcinoma showed mucin secretion from a patulous orifice of the ampulla of Vater and filling defects in the dilated main pancreatic duct by endoscopic retrograde cholangiopancreatography (ERCP). Accurate preoperative diagnosis was not easy regarding either group. Serum carbohydrate antigen 19-9 (CA 19-9) was more useful for diagnosis in both groups.
CONCLUSIONS
The intraductal papillary neoplasm is a unique clinical entity but not a variant of mucinous cystic neoplasm in terms of sex, age, size, tumor location, or pathologic picture. The pathognomonic findings of ERCP should lead to diagnosis. Very aggressive surgical procedures should be attempted for these two mucin-producing neoplasms with low-grade malignancy.