Bussom Scott, Saif Muhammad Wasif
Pharmacology Department, Yale University School of Medicine, New Haven, CT, USA.
JOP. 2010 Mar 5;11(2):131-4.
The diagnosis and treatment of intraductal papillary mucinous tumors (IPMN) of the pancreas has evolved over the last decade. IPMN is a disease of the ductal epithelium and represent a spectrum of disease, ranging from benign to malignant lesions, making the early detection and characterization of these lesions important. As with villous adenomas of the colon, not all IPMNs will develop into adenocarcinoma. Definitive management is surgical resection for appropriate candidates, as benign lesions harbor malignant potential. Growing controversy revolves around issues of natural history, management of small-branch-duct lesions, ability to predict malignancy and/or progression, and surveillance strategies. Given these controversies, novel methods are needed to help in detecting and classifying IPMNs' malignant potential so that appropriate treatment can be administered. The authors review abstracts from the 2010 ASCO Gastrointestinal Cancers Symposium held in January 2010, including biomarkers helping to classify IPMNs: IL-8 and IL-1beta from IPMN cyst aspirates (Abstract #133), and Foxp3/CD4/CD25 cells (Abstract #148) in peripheral blood. Future studies will hopefully provide insight into the many unanswered questions.
在过去十年中，胰腺导管内乳头状黏液性肿瘤（IPMN）的诊断和治疗取得了进展。IPMN是一种导管上皮疾病，代表了一系列疾病，从良性病变到恶性病变，因此对这些病变进行早期检测和特征描述非常重要。与结肠绒毛状腺瘤一样，并非所有IPMN都会发展为腺癌。对于合适的患者，确定性治疗是手术切除，因为良性病变也具有恶性潜能。围绕自然病史、小分支导管病变的管理、预测恶性和/或进展的能力以及监测策略等问题，争议日益增加。鉴于这些争议，需要新的方法来帮助检测和分类IPMN的恶性潜能，以便进行适当的治疗。作者回顾了2010年1月举行的2010年美国临床肿瘤学会（ASCO）胃肠道癌症研讨会的摘要，包括有助于对IPMN进行分类的生物标志物：IPMN囊肿抽吸物中的白细胞介素-8（IL-8）和白细胞介素-1β（IL-1β）（摘要#133），以及外周血中的叉头框P3（Foxp3）/CD4/CD25细胞（摘要#148）。未来的研究有望为许多未解决的问题提供见解。
