Department of Internal Medicine, Toho University Omori Medical Center, Omorinishi, Ohta-ku, Tokyo, Japan.
Dig Endosc. 2010 Apr;22(2):119-23. doi: 10.1111/j.1443-1661.2010.00926.x.
Intraductal papillary-mucinous neoplasm (IPMN) is an intraductal tumor in which the mucin-producing epithelium shows proliferated papillary and a wide variety of pathological changes ranging from hyperplasia to adenocarcinoma. Therefore, it is important to determine whether an IPMN is benign or malignant. In the present study of patients with IPMN, the protrusion was observed by a peroral pancreatoscopy (PPS) using a small-diameter videoscope and narrow-band imaging (NBI). We carried out the differential diagnosis of benign lesion to malignant lesion.
Between April 2003 and May 2009, PPS using a small-diameter videoscope by means of NBI was carried out on 21 hospitalized patients with IPMN (10 cases of adenocarcinoma, 11 cases of adenoma or hyperplasia; 14 males and seven females, with a mean age of 69.4 years).
Fifteen focal lesions of the 16 cases in the head of the pancreas (93.7%) and four focal lesions of the five cases in the pancreatic body (80%) were observable, whereas two lesions (adenocarcinoma in the pancreatic body, and adenoma in the uncus of pancreas) were not observable. Endoscopically, seven cases were classified as villous type and two cases as vegetative type, and nine cases were diagnosed as adenocarcinoma. Ten cases with sessile type or semipedunculated type were diagnosed as adenoma or hyperplasia. Vascular patterns and protrusions were detected more clearly in the NBI images than under white light observation.
When combined with a videoscope and NBI, pancreatoscopy provided a clear image and was useful for evaluating whether the IPMN was benign or malignant.
导管内乳头状黏液性肿瘤（IPMN）是一种发生于导管内的肿瘤，其产生黏液的上皮呈增生性乳头状，并有多种病理变化，从增生到腺癌不等。因此，确定 IPMN 是良性还是恶性非常重要。在本研究中，对 21 例 IPMN 患者进行了经口胰胆管镜检查（PPS），使用小直径内镜和窄带成像（NBI）观察隆起。我们对良性病变和恶性病变进行了鉴别诊断。
2003 年 4 月至 2009 年 5 月，对 21 例住院 IPMN 患者（10 例腺癌，11 例腺瘤或增生；男 14 例，女 7 例，平均年龄 69.4 岁）进行了 PPS 检查，采用小直径内镜结合 NBI。
16 例胰头部病变（93.7%）中 15 例可观察到局灶性病变，5 例胰体部病变中 4 例（80%）可观察到局灶性病变，2 例（胰体部腺癌和胰腺钩突部腺瘤）不可观察。内镜下，7 例为绒毛状，2 例为息肉状，9 例诊断为腺癌。10 例为无蒂型或有蒂型，诊断为腺瘤或增生。NBI 图像比白光观察更能清晰地显示血管模式和隆起。
当与内镜和 NBI 结合使用时，胰胆管镜检查提供了清晰的图像，有助于评估 IPMN 是良性还是恶性。
