Hardacre Jeffrey M, McGee Michael F, Stellato Thomas A, Schulak James A
Department of Surgery, Division of General Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106-5047, USA.
Am J Surg. 2007 Mar;193(3):374-8; discussion 378-9. doi: 10.1016/j.amjsurg.2006.09.029.
Cystic pancreatic neoplasms encompass a range of benign to malignant disease. Recommendations for surgical management vary.
Records of patients with cystic pancreatic neoplasms from January 1996 through December 2005 were retrospectively reviewed.
Sixty resections were performed for 16 serous cystic neoplasms, 7 mucinous cystic neoplasms (MCNs), and 37 intraductal papillary mucinous neoplasms (IPMNs). Twenty-five percent (15/60) of neoplasms contained invasive cancer. Patients with MCN or IPMN invasive neoplasms experienced significantly diminished overall 5-year survival compared to patients with IPMN carcinoma in situ neoplasms and to patients with MCN or IPMN adenoma/borderline neoplasms (22% vs. 73% vs. 94%, P = .004).
Given the poor long-term survival of patients with cystic pancreatic neoplasms containing invasive cancer and the current difficulty to preoperatively distinguish among the various types of lesions in a reliable manner, our data support an aggressive surgical approach to the management of cystic pancreatic neoplasms.
胰腺囊性肿瘤涵盖了一系列从良性到恶性的疾病。手术管理的建议各不相同。
回顾性分析了1996年1月至2005年12月期间胰腺囊性肿瘤患者的记录。
对16例浆液性囊性肿瘤、7例黏液性囊性肿瘤（MCN）和37例导管内乳头状黏液性肿瘤（IPMN）进行了60例切除术。25%（15/60）的肿瘤含有浸润性癌。与原位IPMN癌患者以及MCN或IPMN腺瘤/交界性肿瘤患者相比，MCN或IPMN浸润性肿瘤患者的总体5年生存率显著降低（22%对73%对94%，P = 0.004）。
鉴于含有浸润性癌的胰腺囊性肿瘤患者长期生存率较低，且目前难以可靠地术前区分各种类型的病变，我们的数据支持对胰腺囊性肿瘤采取积极的手术治疗方法。
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