Department of Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Surgery. 2010 Jun;147(6):812-7. doi: 10.1016/j.surg.2009.11.011. Epub 2010 Jan 8.
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is divided into 4 subtypes: an intestinal type, a gastric type, a pancreatobiliary type, and an oncocytic type. The purposes of this study were to clarify the outcomes and the characteristics of invasive carcinoma derived from IPMN (invasive IPMC) by focusing on these subtypes with a comparison to conventional invasive ductal carcinoma (IDC) of the pancreas.
A total of 30 patients with invasive IPMC were reviewed, and the tumors were divided into 2 pathologic subtypes, intestinal and nonintestinal type. The prognosis and characteristics of the 2 subtypes were evaluated. Furthermore, the prognosis of 119 patients with conventional IDC was compared with that of patients with invasive carcinoma derived from the intestinal or nonintestinal type IPMN.
The 5-year survival rate of patients with the nonintestinal type (0.0%) was as poor as that of patients with conventional IDC (19.9%; P = .67). The patients with the intestinal type (66.7%) had a more favorable prognosis than patients with conventional IDC (P < .001). The nonintestinal type was characterized by positive lymphatic invasion and tubular invasive pattern.
Invasive carcinoma derived from the nonintestinal type IPMN characterized by lymphatic invasion and tubular invasive pattern is associated with a poor prognosis.
胰腺内导管乳头状黏液性肿瘤（IPMN）分为 4 个亚型：肠型、胃型、胰胆管型和嗜酸性细胞型。本研究旨在通过比较胰腺内导管腺癌（IDC）来阐明以这些亚型为重点的侵袭性 IPMN（侵袭性 IPMC）的结果和特征。
回顾性分析了 30 例侵袭性 IPMC 患者，将肿瘤分为肠型和非肠型 2 种病理亚型，评估 2 种亚型的预后和特征。此外，还比较了 119 例常规 IDC 患者与肠型或非肠型 IPMN 衍生的侵袭性癌患者的预后。
非肠型患者的 5 年生存率（0.0%）与常规 IDC 患者（19.9%）相当（P =.67）。肠型患者（66.7%）的预后优于常规 IDC 患者（P <.001）。非肠型的特点是存在阳性淋巴管浸润和管状浸润模式。
以淋巴管浸润和管状浸润模式为特征的非肠型 IPMN 衍生的侵袭性癌与预后不良相关。
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