Hruban Ralph H, Maitra Anirban, Kern Scott E, Goggins Michael
Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins Medical Institutions, Baltimore, MD 21231, USA.
Gastroenterol Clin North Am. 2007 Dec;36(4):831-49, vi. doi: 10.1016/j.gtc.2007.08.012.
Infiltrating ductal adenocarcinoma of the pancreas is believed to arise from morphologically distinct noninvasive precursor lesions. These precursors include the intraductal papillary mucinous neoplasm, the mucinous cystic neoplasm, and pancreatic intraepithelial neoplasia. Intraductal papillary mucinous neoplasms are grossly visible mucin-producing epithelial neoplasms that arise in the main pancreatic duct or one of its branches. The cysts of mucinous cystic neoplasms do not communicate with the major pancreatic ducts, and these neoplasms are characterized by a distinct ovarian-type stroma. Pancreatic intraepithelial neoplasia is a microscopic lesion. This article focuses on the clinical significance of these three important precursor lesions, with emphasis on their clinical manifestations, detection, and treatment.
胰腺浸润性导管腺癌被认为起源于形态学上不同的非侵袭性前驱病变。这些前驱病变包括导管内乳头状黏液性肿瘤、黏液性囊性肿瘤和胰腺上皮内瘤变。导管内乳头状黏液性肿瘤是肉眼可见的产生黏液的上皮性肿瘤，发生于主胰管或其分支之一。黏液性囊性肿瘤的囊肿不与主胰管相通，这些肿瘤的特征是具有独特的卵巢型间质。胰腺上皮内瘤变是一种微观病变。本文重点关注这三种重要前驱病变的临床意义，重点在于它们的临床表现、检测和治疗。
