Yoon Won Jae, Lee Jun Kyu, Lee Kwang Hyuck, Ryu Ji Kon, Kim Yong-Tae, Yoon Yong Bum
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Pancreas. 2008 Oct;37(3):254-8. doi: 10.1097/MPA.0b013e3181676ba4.
The purpose of this study was to update a previous study of cystic neoplasms of the pancreas (PCNs) conducted in Korea by the authors.
Clinicopathologic data and factors associated with malignancy were evaluated from PCNs originating from the exocrine pancreas diagnosed between January 1993 and June 2005 in 30 university hospitals throughout Korea.
A total of 1064 pathologically confirmed PCNs, which consisted of the following diagnoses, were collected: intraductal papillary mucinous neoplasm (IPMN), 436; mucinous cystic neoplasm (MCN), 268; solid pseudopapillary neoplasm (SPN), 195; serous cystic neoplasm (SCN), 162; acinar cell cystic neoplasm 2; and mature teratoma, 1. No malignant SCNs were diagnosed. In IPMN, advanced age, pancreatic head involvement, and hyperbilirubinemia were associated with malignancy based on multivariate analysis. In MCN, pancreatic head involvement was associated with malignancy based on multivariate analysis.
Intraductal papillary mucinous neoplasms were the most common PCN observed in Korea. Solid pseudopapillary neoplasms were observed more frequently than those in studies from western countries. In IPMNs, advanced age was associated with malignancy, suggesting an adenoma-carcinoma sequence. Involvement of the pancreatic head was associated with malignancy in both IPMNs and MCNs, possibly warranting prompt surgical interventions.
本研究旨在更新作者之前在韩国进行的一项胰腺囊性肿瘤（PCNs）研究。
对1993年1月至2005年6月间韩国30家大学医院诊断的起源于胰腺外分泌部的PCNs的临床病理数据及与恶性肿瘤相关的因素进行评估。
共收集到1064例经病理确诊的PCNs，诊断包括以下几种：导管内乳头状黏液性肿瘤（IPMN）436例；黏液性囊性肿瘤（MCN）268例；实性假乳头状肿瘤（SPN）195例；浆液性囊性肿瘤（SCN）162例；腺泡细胞囊性肿瘤2例；成熟畸胎瘤1例。未诊断出恶性SCN。在IPMN中，多因素分析显示高龄、胰头受累和高胆红素血症与恶性肿瘤相关。在MCN中，多因素分析显示胰头受累与恶性肿瘤相关。
导管内乳头状黏液性肿瘤是韩国观察到的最常见的PCN。实性假乳头状肿瘤的观察频率高于西方国家的研究。在IPMN中，高龄与恶性肿瘤相关，提示腺瘤-癌序列。胰头受累在IPMN和MCN中均与恶性肿瘤相关，可能需要及时进行手术干预。
