Pancreatic Mucinous Cystic Neoplasm Defined by Ovarian Stroma: Demographics, Clinical Features, and Prevalence of Cancer
Pancreatic Mucinous Cystic Neoplasm Defined by Ovarian Stroma: Demographics, Clinical Features, and Prevalence of Cancer
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DOI：
10.1016/s1542-3565(04)00450-1
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发表时间：
2004-11-01
影响因子：
12.6
通讯作者：
Chari, Suresh T.
中科院分区：
文献类型：
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作者：
Reddy, Raghuram P.;Smyrk, Thomas C.;Chari, Suresh T.
背景和目的：胰腺产生粘蛋白的囊性肿瘤分为两种不同的实体：粘液性囊性肿瘤（MCN）和导管内乳头状粘液性肿瘤（IPMN）。在以前的研究中，MCN 的定义通常比较宽松，并且并不总是与 IPMN 明确区分。我们的目的是确定 MCN 中的人口统计学、临床特征和侵袭性癌症的患病率（通过特征性卵巢基质的存在来定义）。方法：通过使用卵巢间质的存在作为诊断 MCN 的必要标准，一位病理学家在不了解临床信息的情况下，从 Mayo Clinic 1986 年至 2003 年间切除的 243 个产生粘蛋白的肿瘤中鉴定出 56 个 MCN。审查了 MCN 患者的医疗记录，以获得临床和人口统计数据。结果：MCN 患者几乎全部 (98%) 为女性；我们发现 1 名男子患有含有卵巢间质的肿瘤。切除时的平均 (+/- SD) 年龄为 48 +/- 15 岁 (84% < 60 岁)。腹痛是最常见的症状； 16%无症状。大多数 MCN (93%) 位于胰体/尾部区域。他们的中位尺寸为 5 厘米（61% >= 5 厘米）。组织学上，50 例（89%）为腺瘤，2 例（4%）为原位癌，4 例（7%）为浸润性癌。 22 个尺寸 < 5 cm 的 MCN 中没有一个患有浸润性癌症。患有非侵袭性疾病的患者在切除后没有复发。结论：由卵巢间质定义的 MCN 具有独特的人口统计学和临床特征，且侵袭性癌症的患病率较低。这些观察结果表明，卵巢间质应作为诊断 MCN 的明确标准。
Background & Aims: Pancreatic mucin-producing cystic neoplasms are classified into 2 distinct entities: mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN). In previous studies, MCN often has been defined loosely and has not always been distinguished clearly from IPMN. Our aims were to determine the demographics, clinical features, and prevalence of invasive cancer in MCN defined by the presence of characteristic ovarian stroma. Methods: By using the presence of ovarian stroma as a requisite criterion for diagnosis of MCN, a single pathologist, unaware of clinical information, identified 56 MCNs from 243 mucin-producing neoplasms resected at Mayo Clinic between 1986 and 2003. Medical records of the MCN patients were reviewed to obtain clinical and demographic data. Results: Patients with MCN were almost exclusively (98%) women; we identified 1 man with a neoplasm containing ovarian stroma. The mean (+/- SD) age at resection was 48 +/- 15 years (84% < 60 y). Abdominal pain was the most common presenting symptom; 16% were asymptomatic. Most MCN (93%) were in the pancreatic body/tail region. Their median size was 5 cm (61% >= 5 cm). Histologically, 50 (89%) were adenomas, 2 (4%) had carcinoma-in-situ, and 4 (7%) had invasive cancer. None of the 22 MCNs < 5 cm in size had invasive cancer. No patient with noninvasive disease had a recurrence after resection. Conclusions: MCN defined by ovarian stroma has a distinct demographic and clinical profile and a low prevalence of invasive cancer. These observations suggest that ovarian stroma should be used as the defining criterion for diagnosing MCN.