胰腺侵袭性导管内乳头状黏液性肿瘤:与胰腺导管腺癌的比较
Invasive intraductal papillary-mucinous neoplasm of the pancreas: comparison with pancreatic ductal adenocarcinoma.
作者信息
Murakami Yoshiaki, Uemura Kenichiro, Sudo Takeshi, Hayashidani Yasuo, Hashimoto Yasushi, Nakashima Akira, Sueda Taijiro
机构信息
Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
出版信息
J Surg Oncol. 2009 Jul 1;100(1):13-8. doi: 10.1002/jso.21290.
BACKGROUND AND OBJECTIVES
The aim of this study was to clarify the clinicopathological differences between patients with invasive intraductal papillary-mucinous neoplasm (IPMN) of the pancreas and pancreatic ductal adenocarcinoma.
METHODS
The medical records of 16 patients with invasive IPMN and 106 patients with pancreatic ductal adenocarcinoma, who underwent surgical resection, were retrospectively reviewed, and the clinicopathological factors and survival were compared between the two groups.
RESULTS
The presence of retroperitoneal tissue invasion, portal or splenic vein invasion, nodal involvement, and positive surgical margins were significantly lower in patients with invasive IPMN than in those with ductal adenocarcinoma (P < 0.05). The actuarial 5-year overall survival rates in patients with invasive IPMN and ductal carcinoma were 40% and 18%, respectively (P = 0.008). However, the actuarial 5-year survival rate of patients with invasive IPMN was only 27% for UICC stage II disease, although this was significantly higher than that of patients with UICC stage II ductal adenocarcinoma (P = 0.049).
CONCLUSIONS
Invasive IPMN has a favorable prognosis compared with pancreatic ductal adenocarcinoma that is likely due to the less aggressive nature of the disease. However, the prognosis for cases of advanced invasive IPMN is not always favorable despite complete tumor resection.
背景与目的
本研究旨在阐明胰腺浸润性导管内乳头状黏液性肿瘤(IPMN)患者与胰腺导管腺癌患者之间的临床病理差异。
方法
回顾性分析16例接受手术切除的浸润性IPMN患者和106例胰腺导管腺癌患者的病历,比较两组的临床病理因素及生存率。
结果
浸润性IPMN患者的腹膜后组织侵犯、门静脉或脾静脉侵犯、淋巴结受累及手术切缘阳性的发生率显著低于导管腺癌患者(P < 0.05)。浸润性IPMN患者和导管癌患者的5年总生存率分别为40%和18%(P = 0.008)。然而,UICC II期浸润性IPMN患者的5年生存率仅为27%,尽管这显著高于UICC II期导管腺癌患者(P = 0.049)。
结论
与胰腺导管腺癌相比,浸润性IPMN预后较好,这可能是由于该疾病侵袭性较弱。然而,尽管肿瘤已完全切除,晚期浸润性IPMN病例的预后并不总是良好。