Pitman Martha Bishop, Michaels Paul J, Deshpande Vikram, Brugge William R, Bounds Brenna C
James Homer Wright Pathology Laboratories and Cytopathology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Pancreatology. 2008;8(3):277-84. doi: 10.1159/000134276. Epub 2008 May 22.
BACKGROUND/AIM: Management of patients with small (1-3 cm) branch duct intraductal papillary mucinous neoplasms (IPMN) is a challenge. Symptoms, dilated duct, mural nodule or positive cytology have been proposed as parameters for resection. The aim of our study was to compare this proposed algorithm to one that incorporates cytology with less than malignant epithelial cells and cyst fluid carcinoembryonic antigen (CEA).
A retrospective study was conducted.
There were 14 nonmalignant and 6 malignant cysts with 3 invasive IPMN. None were associated with a dilated duct and none had positive cytology. Only a mural nodule was significant by univariate analysis for the detection of malignancy (p = 0.01) and invasion (p = 0.009). The detection of atypical epithelial cells or a cyst fluid CEA of >2,500 ng/ml was more accurate for the detection of malignancy than using the recommended algorithm.
The presence of a mural nodule in a small branch duct IPMN is a predictor of malignancy and invasion by univariate analysis. Recognition of an atypical epithelial cell component in contrast to positive cytology or a cyst fluid CEA of >2,500 ng/ml is more accurate than the recommended algorithm and adds value to the preoperative assessment of clinically diagnosed small branch duct IPMN. and IAP.
背景/目的：小（1 - 3厘米）分支导管内乳头状黏液性肿瘤（IPMN）患者的管理是一项挑战。症状、扩张的导管、壁结节或阳性细胞学检查已被提议作为切除的参数。我们研究的目的是将这种提议的算法与一种结合了非恶性上皮细胞和囊液癌胚抗原（CEA）的细胞学检查的算法进行比较。
进行了一项回顾性研究。
有14个非恶性囊肿和6个恶性囊肿，其中3个为浸润性IPMN。均未伴有扩张的导管，也均无阳性细胞学检查结果。单因素分析显示，仅壁结节对于检测恶性肿瘤（p = 0.01）和浸润（p = 0.009）具有显著意义。对于检测恶性肿瘤，检测非典型上皮细胞或囊液CEA>2500 ng/ml比使用推荐算法更准确。
通过单因素分析，小分支导管IPMN中壁结节的存在是恶性肿瘤和浸润的预测指标。与阳性细胞学检查或囊液CEA>2500 ng/ml相比，识别非典型上皮细胞成分更准确，比推荐算法更具优势，可为临床诊断的小分支导管IPMN的术前评估增添价值。 以及IAP。
