Two types of mucin-producing cystic tumors of the pancreas: diagnosis and treatment.
Two types of mucin-producing cystic tumors of the pancreas: diagnosis and treatment.
复制标题
两种类型的产生粘蛋白的胰腺囊性肿瘤：诊断和治疗。
DOI：
10.1016/s0039-6060(97)90136-7
复制
发表时间：
1997
期刊：
影响因子：
3.8
通讯作者：
A. Kuroda
中科院分区：
文献类型：
--
作者：
M. Sugiyama;Y. Atomi;A. Kuroda
研究背景本研究旨在探讨两种类型的胰腺粘液性囊性肿瘤的临床病理、影像表现及预后的差异，以期对这两种类型的肿瘤进行适当的治疗。肿瘤类型：粘液性囊性肿瘤6例，腺瘤6例，腺癌12例，导管内乳头状瘤10例，腺癌18例。粘液性囊腺癌比导管内乳头状腺癌更易受侵袭。58%的粘液性囊腺癌有淋巴转移，而导管内乳头状腺癌只有22%。伴有附壁结节的肿瘤更倾向于表现为深层侵袭和淋巴结转移。4例直径小于3 cm的导管内乳头状瘤均为腺瘤，无壁结节。影像研究可以准确区分这两种类型，但不能对腺瘤和腺癌进行区分。腺瘤、粘液性囊腺癌和导管内乳头状腺癌患者的5年生存率分别为100%、33%和81%。结论粘液性囊性肿瘤需要彻底切除肿瘤并广泛清扫包括腹主动脉旁淋巴结在内的淋巴结。导管内乳头状瘤仅需清扫胰周结节；对于直径小于3 cm且无壁结节的肿瘤，可能不需要清扫结节。
BackgroundThis study focuses on clinicopathologic, imaging, and prognostic differences between two types of mucin-producing cystic tumors of the pancreas, with the aim of appropriate management of these tumors.MethodsForty-six patients with mucin-producing cystic tumors underwent operation. The types of tumors were as follows: mucinous cystic neoplasm, adenoma (6) and adenocarcinoma (12); intraductal papillary tumor, adenoma (10) and adenocarcinoma (18).ResultsGender, age, symptoms, signs, tumor location and size, and the presence or absence of communication with the pancreatic duct differed between the two types. Mucinous cystadenocarcinomas showed deep invasion more often than intraductal papillary adenocarcinomas. Lymph node involvement was seen in 58% of mucinous cystadenocarcinomas but in only 22% of intraductal papillary adenocarcinomas. Tumors with mural nodules tended to show deep invasion and nodal metastasis. All four intraductal papillary tumors smaller than 3 cm without mural nodules were adenomas. Imaging studies allowed accurate differentiation between the two types but not between adenomas and adenocarcinomas. Five-year survival rates for patients with adenomas, mucinous cystadenocarcinomas, and intraductal papillary adenocarcinomas were 100%, 33%, and 81%, respectively.ConclusionsMucinous cystic neoplasm necessitates complete tumor excision with wide dissection of lymph nodes including paraaortic nodes. Intraductal papillary tumor requires only peripancreatic node dissection; for tumors smaller than 3 cm without mural nodules, node dissection may be unnecessary.