Kubo H, Nakamura K, Itaba S, Yoshinaga S, Kinukawa N, Sadamoto Y, Ito T, Yonemasu H, Takayanagi R
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
Endoscopy. 2009 Aug;41(8):684-9. doi: 10.1055/s-0029-1214952. Epub 2009 Aug 10.
Generally, cystic tumors are divided into two categories: neoplastic cystic tumors and non-neoplastic cystic (NNC) tumors. Neoplastic cystic tumors include mucinous cystic neoplasm (MCN), intraductal papillary-mucinous neoplasm (IPMN), and serous cystic neoplasm (SCN). MCNs and IPMNs have the potential to progress to a malignant state, whereas SCNs are known for their almost benign behavior. Thus, in order to make management decisions, it is important to distinguish between potentially malignant (MCN and IPMN), and benign (SCN and NNC) tumors. The aim of this study was to retrospectively investigate the value of endoscopic ultrasonography (EUS) for the differential diagnosis of cystic tumors of the pancreas.
A total of 76 patients with cystic tumors of the pancreas were preoperatively examined by EUS. Eight cases were MCNs, 45 were IPMNs, 13 were SCNs, and 10 were NNC tumors. The EUS findings relevant to distinguishing between potentially malignant and benign were analyzed statistically.
All patients with MCNs were female and all these tumors were located in the pancreatic body/tail. IPMN, however, occurred predominantly in men, and in the pancreatic head. Eight of 11 monolocular cystic tumors were NNC in nature. Eleven of 13 SCNs included microcystic areas within the tumors. All MCNs were round in appearance, whereas 93 % of IPMNs were not round in appearance. Mural nodules were present in 25 % of MCN and 38 % of IPMN cases. In univariate analysis, age, tumor size, locularity, the number of cystic formation, cystic component, and appearance were significant variables. In multivariate analysis, locularity and cystic component were important for differential diagnosis of potentially malignant cystic tumors.
The characteristics of cystic tumors of the pancreas revealed by EUS are useful for their differential diagnosis.
一般来说，囊性肿瘤分为两类：肿瘤性囊性肿瘤和非肿瘤性囊性（NNC）肿瘤。肿瘤性囊性肿瘤包括黏液性囊性肿瘤（MCN）、导管内乳头状黏液性肿瘤（IPMN）和浆液性囊性肿瘤（SCN）。MCN和IPMN有进展为恶性状态的可能，而SCN以其几乎良性的行为而闻名。因此，为了做出管理决策，区分潜在恶性（MCN和IPMN）和良性（SCN和NNC）肿瘤很重要。本研究的目的是回顾性研究内镜超声（EUS）在胰腺囊性肿瘤鉴别诊断中的价值。
共有76例胰腺囊性肿瘤患者术前行EUS检查。其中8例为MCN，45例为IPMN，13例为SCN，10例为NNC肿瘤。对与区分潜在恶性和良性相关的EUS表现进行统计学分析。
所有MCN患者均为女性，所有这些肿瘤均位于胰体/尾部。然而，IPMN主要发生在男性，且位于胰头。11个单房性囊性肿瘤中有8个本质上为NNC。13个SCN中有11个在肿瘤内包含微囊性区域。所有MCN外观均为圆形，而93%的IPMN外观不是圆形。25%的MCN和38%的IPMN病例存在壁结节。在单因素分析中，年龄、肿瘤大小、分叶情况、囊性形成数量、囊性成分和外观是显著变量。在多因素分析中，分叶情况和囊性成分对潜在恶性囊性肿瘤的鉴别诊断很重要。
EUS显示的胰腺囊性肿瘤特征对其鉴别诊断有用。
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