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[胰腺囊性肿瘤:诊断、管理与结果]

[Cystic tumors of the pancreas: diagnosis, management and results].

作者信息

Alfieri Sergio, Pericoli Ridolfini Marco, Bassi Claudio, Gourgiotis Stavros, Caprino Paola, Pederzoli Paolo, Sofo Luigi, Doglietto Giovanni Battista

机构信息

Dipartimento di Scienze Chirurgiche, Unità di Chirurgia Digestiva, Università Cattolica del Sacro Cuore, Roma.

出版信息

Chir Ital. 2008 Jul-Aug;60(4):493-508.

Abstract

Pancreatic cystic tumours are rare and less frequent than other pancreatic tumours. In recent decades, these tumours are being diagnosed with increasing frequency due to the extensive availability of, and improvement in, modern imaging techniques and it is often possible not only to differentiate them preoperatively from other cystic pancreatic disorders but also from one another. Pancreatic cystic tumours comprise a variety of neoplasms with a wide range of malignant potential: serous cystic tumours are benign, whereas mucinous cystic tumours, and intraductal papillary mucinous tumours are considered premalignant, while solid pseudopapillary tumours have a non-aggressive behaviour in the vast majority of cases. Most patients have no symptoms; and when clinical signs are present, they never help us to identify the type of pathology. Serous cystic neoplasms usually do not mandate resection unless the lesion is symptomatic. Mucinous cystic neoplasms and intraductal papillary mucinous neoplasms have a premalignant or malignant tendency, and therefore need to be managed aggressively by pancreatic resection. Their prognosis is excellent in the absence of invasive disease, but the presence of invasive malignancy is associated with a poor prognosis. This review addresses the symptoms, diagnosis, management and prognosis of this group of tumours.

摘要

胰腺囊性肿瘤较为罕见,比其他胰腺肿瘤的发病率更低。近几十年来,由于现代成像技术的广泛应用和不断改进,这些肿瘤的诊断频率越来越高,而且通常不仅能够在术前将它们与其他胰腺囊性疾病区分开来,还能相互鉴别。胰腺囊性肿瘤包括多种具有广泛恶性潜能的肿瘤:浆液性囊性肿瘤是良性的,而黏液性囊性肿瘤和导管内乳头状黏液性肿瘤被认为是癌前病变,实性假乳头状肿瘤在绝大多数情况下行为不具侵袭性。大多数患者没有症状;而当出现临床体征时,这些体征也无法帮助我们确定病理类型。浆液性囊性肿瘤通常不需要进行切除,除非病变有症状。黏液性囊性肿瘤和导管内乳头状黏液性肿瘤有癌前或恶性倾向,因此需要通过胰腺切除术积极治疗。在没有侵袭性疾病的情况下,它们的预后良好,但存在侵袭性恶性肿瘤则预后较差。本文综述了这类肿瘤的症状、诊断、治疗和预后。

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