Department of Gastroenterological, General, Breast and Thyroid Surgery, Faculty of Medicine, Yamagata University, Yamagata City, Japan.
Pancreas. 2010 Jul;39(5):604-10. doi: 10.1097/MPA.0b013e3181c6947a.
Intraductal papillary-mucinous neoplasms (IPMNs) of the pancreas are classified into 4 types--gastric, intestinal, pancreatobiliary, and oncocytic--on the basis of their morphology and immunohistochemistry. We classified IPMNs at our institute and used this classification to determine the clinicopathological features, prognosis, and malignant potential of the 4 types.
Sixty-one patients with IPMN who underwent surgery between 2000 and 2007 were evaluated retrospectively.
There were 24 tumors of the gastric type, 22 intestinal, 12 pancreatobiliary, and 3 oncocytic. Patients with the intestinal or gastric type had a better prognosis than those with the pancreatobiliary type. The intestinal and pancreatobiliary types had almost the same frequencies of carcinoma, but the intestinal type tended to have a lower frequency of invasive carcinoma than the pancreatobiliary type. Patients with invasive carcinomas derived from intestinal-type IPMNs tended to have a better prognosis than those whose invasive carcinomas were derived from the pancreatobiliary type.
Intraductal papillary-mucinous neoplasm of the gastric and intestinal types may have less malignant potential than that of the pancreatobiliary type. Invasive carcinomas derived from intestinal-type IPMNs may be less invasive and slower growing than those derived from the pancreatobiliary type.
胰腺导管内乳头状黏液性肿瘤（IPMN）基于其形态学和免疫组织化学可分为胃型、肠型、胰胆管型和嗜酸细胞型 4 种类型。我们对本院的 IPMN 进行了分类，并使用该分类方法来确定 4 种类型的临床病理特征、预后和恶性潜能。
回顾性分析 2000 年至 2007 年间手术治疗的 61 例 IPMN 患者。
胃型肿瘤 24 例，肠型 22 例，胰胆管型 12 例，嗜酸细胞型 3 例。肠型或胃型患者的预后优于胰胆管型患者。肠型和胰胆管型的癌发生率几乎相同，但肠型的浸润性癌发生率低于胰胆管型。来源于肠型 IPMN 的浸润性癌患者的预后优于来源于胰胆管型的患者。
胃型和肠型 IPMN 的恶性潜能可能低于胰胆管型。来源于肠型 IPMN 的浸润性癌可能比来源于胰胆管型的浸润性癌侵袭性更小、生长更慢。
