Monneuse Olivier Jean-Yves, Rochette Anne, Pilleul Frank
Service de Chirurgie Digestive et d'Urgence, Pavillon G Viscéral, Hospices civils de Lyon, Hôpital Edouard Herriot.
Presse Med. 2006 Apr;35(4 Pt 2):669-78. doi: 10.1016/s0755-4982(06)74661-9.
Reports of intraductal papillary mucinous tumors of the pancreas have become substantially more frequent in the literature in the past several years. This increased prevalence is due, among other things, to improved screening techniques, especially high-resolution spatial imaging. These tumors are characterized by proliferation of the intraductal epithelium, mucin production, and ductal dilatation. They grow slowly. Their potential for malignancy is high (although the precise risk remains difficult to assess), but their prognosis, when identified during the first stage of neoplastic transformation (before invasion), is far better than that of 'pancreatic ductal adenocarcinoma. Early diagnosis allows patients to be treated before carcinomatous degeneration. Specific diagnosis makes it possible to define an appropriate treatment strategy - either surgery or monitoring, especially when only the intralobular ducts are affected. In that case, the risk of malignant degeneration is much lower than with lesions in the pancreatic duct or in combined forms.
在过去几年里，胰腺导管内乳头状黏液性肿瘤的报告在文献中变得显著更加频繁。这种患病率的增加尤其归因于筛查技术的改进，特别是高分辨率空间成像。这些肿瘤的特征是导管内上皮细胞增殖、黏液产生和导管扩张。它们生长缓慢。其恶变潜能很高（尽管确切风险仍难以评估），但在肿瘤转化的第一阶段（侵袭前）被发现时，其预后远比胰腺导管腺癌要好。早期诊断可使患者在癌变前得到治疗。特异性诊断使得确定合适的治疗策略成为可能——手术或监测，尤其是当仅小叶内导管受累时。在这种情况下，恶变风险远低于胰腺导管或联合形式的病变。
