Long-term follow-up of intraductal papillary mucinous neoplasm of the pancreas with ultrasonography.
Long-term follow-up of intraductal papillary mucinous neoplasm of the pancreas with ultrasonography.
复制标题
超声检查对胰腺导管内乳头状粘液性肿瘤的长期随访。
DOI：
10.1016/s1542-3565(05)00756-1
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
H. Saisho
中科院分区：
文献类型：
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作者：
Taketo Yamaguchi;Takeshi Baba;T. Ishihara;A. Kobayashi;Kazuyoshi Nakamura;H. Tadenuma;Hiroshi Ito;M. Miyazaki;H. Saisho
背景与目的大多数胰腺导管内乳头状粘液性肿瘤 (IPMN) 预后良好。本研究的目的是在定期经腹超声检查（US）长期随访的基础上阐明IPMN的临床病程并制定手术治疗标准。方法81例IPMN患者定期接受US检查（>3年）； 27 例进行了回顾性回顾（12 例为良性肿瘤[腺瘤、交界性肿瘤]，15 例为恶性肿瘤[原位癌、浸润性癌]），另外 54 例进行了前瞻性回顾。超声检查的重点是主胰管（MPD）直径、囊肿直径以及突出病变的有无和高度。检查良性组和恶性组之间的差异以确定手术治疗的标准。对前瞻性患者的随访结果进行了调查。结果恶性组中 MPD 或囊肿直径的增加显着更大（P < .01）。 MPD 直径最大增加 2.2 毫米/年，囊肿直径最大增加 11.3 毫米/年，突出病变的出现或高度增加 3.3 毫米/年主要在恶性组中观察到（准确度分别为 90.9%、81.3% 和 81.5%）。大多数预期患者的这些参数没有显着变化；然而，2 名患者 (3.7%) 接受了手术，术后组织病理学诊断为癌症。 结论 定期影像学随访有助于检测恶性 IPMN。 MPD 直径、囊肿直径和/或突出病变大小的变化是选择手术的实际标准。
Background & AimsMost intraductal papillary mucinous neoplasms of the pancreas (IPMNs) have a favorable prognosis. This study was undertaken to clarify the clinical course of IPMNs and to set the criteria for surgical treatment on the basis of long-term follow-up by periodic transabdominal ultrasonography (US).MethodsEighty-one patients with IPMN were periodically subjected to US (>3 years); 27 were reviewed retrospectively (12 with benign neoplasms [adenoma, borderline] and 15 with malignant tumors [carcinoma in situ, invasive cancer]) and 54 prospectively. US examination was focused on the main pancreatic duct (MPD) diameter, cyst diameter, and presence or absence and height of the protruding lesion. Differences between the benign and malignant groups were examined to set the criteria for surgical treatment. Follow-up results of prospective patients were investigated.ResultsThe increase of the MPD or the cyst diameter was significantly greater in the malignant group (P < .01). Maximum increases of the MPD diameter by 2.2 mm/year, the cyst diameter by 11.3 mm/year, and emergence or increase of the height of the protruding lesion by 3.3 mm/year were predominantly observed in the malignant group (accuracy, 90.9%, 81.3%, and 81.5%, respectively). The majority of the prospective patients showed no significant changes of these parameters; however, 2 patients (3.7%) were operated on, with the post-surgery histopathologic diagnosis of cancer.ConclusionsPeriodic imaging follow-up is useful to detect a malignant IPMN. Changes in MPD diameter, cyst diameter, and/or size of the protruding lesion are the practical criteria for selecting surgery.