Peroral pancreatoscopy in the diagnosis of mucin-producing tumors of the pancreas
Peroral pancreatoscopy in the diagnosis of mucin-producing tumors of the pancreas
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DOI：
10.1067/mge.2000.105721
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发表时间：
2000-07-01
影响因子：
7.7
通讯作者：
Saisho, H
中科院分区：
文献类型：
--
作者：
Yamaguchi, T;Hara, T;Saisho, H
背景：胰腺粘液瘤是一个越来越被认可的临床实体。然而，胰腺的良性和恶性产生粘蛋白的肿瘤的鉴别是具有挑战性的。经口胰镜检查，最近开发的可能有潜力的诊断粘液分泌肿瘤的pancreat.Methods：受试者是41例临床诊断的胰腺粘液分泌肿瘤，其中40人进行了手术切除。另一例不可切除疾病患者的尸检结果可用。组织学上，3例患者被确定为增生，11例轻度不典型腺瘤，16例重度不典型腺瘤，11例腺癌。术前或病理检查前均行经口胰镜检查。结果：30例（73.2%）患者的胰腺镜检查成功。在22例（73.3%）中发现了隆起病变。严重不典型腺瘤或腺癌常可见绒毛状或植物性隆起及红色斑纹。肿瘤的位置（主要或分支导管类型）与切除后的生存率无关。30例非恶性肿瘤中有7例进行了部分切除，结果良好outcomes.Conclusion：经口胰管镜检查可用于区分胰腺良性粘液分泌肿瘤（增生和轻度不典型腺瘤）与不典型病变（严重不典型腺瘤和腺癌），并可提供有用的信息，以确定要进行的手术类型。
Background: Mucin-producing tumor of the pancreas is an increasingly recognized clinical entity. However, the differentiation of benign from malignant mucin-producing tumors of the pancreas is challenging. Peroral pancreatoscopy as recently developed may have potential for the diagnosis of mucin-producing tumors of the pancreas.Methods: The subjects were 41 patients with clinically diagnosed mucin-producing tumors of the pancreas, 40 of whom underwent surgical resection. Autopsy findings were available in another patient with unresectable disease. Histologically, hyperplasia was identified in 3 patients, mildly atypical adenoma in 11, severely atypical adenoma in 16, and adenocarcinoma in 11. Peroral pancreatoscopy was performed before surgery or pathologic examination. The findings were retrospectively evaluated and compared with the histopathologic diagnosis.Results: Pancreatoscopic observation was successful in 30 patients (73.2%). Elevated lesions were identified in 22 (73.3%). Villous or vegetative elevations and red color markings were frequently found in severely atypical adenoma or adenocarcinoma. Tumor location (main or branch duct type) did not correlate with survival after resection. Partial resection was performed in 7 of 30 patients with nonmalignant tumors and resulted in favorable outcomes.Conclusion: Peroral pancreatoscopy can be used to differentiate benign mucin-producing tumors of the pancreas (hyperplasia and mildly atypical adenoma) from the more dysplastic lesions (severely atypical adenoma and adenocarcinoma) and may provide useful information for determining the type of surgery to be performed.