胆管内乳头状黏液性肿瘤：一种真正的疾病？
Intraductal papillary mucinous neoplasm of the biliary tract: a real disease?
出版信息
HPB (Oxford). 2009 Dec;11(8):684-91. doi: 10.1111/j.1477-2574.2009.00122.x.
BACKGROUND
Despite increasing numbers of reports, biliary tract intraductal papillary mucinous neoplasm (BT-IPMN) is not yet recognized as a unique neoplasm. The aim of the present study was to define the presence of BT-IPMN in a large series of resected biliary neoplasms.
METHODS
From May 1994 to December 2006, BT-IPMN cases were identified by reviewing pathology specimens of all resected cholangiocarcinomas and other biliary neoplasms when cystic, papillary or mucinous features were cited in pathology reports.
RESULTS
BT-IPMN was identified in 23 out of 253 (9%) specimens using the strict histopathological criteria of IPMN. The most common presenting symptom was abdominal discomfort which was present in 15 patients (65%). Only one of the original operative pathology reports used the term IPMN; 16 (70%) used the terms cystic, mucinous and/or papillary. BT-IPMN was isolated to non-hilar extra-hepatic ducts in 12 (52%), intra-hepatic ducts in 6 (26%) and hilar extra-hepatic ducts in 5 patients (22%). Carcinoma was found in association with BT-IPMN in 19 patients (83%); 5-year survival was 38% after resection.
CONCLUSION
BT-IPMN occurs throughout the intra- and extra-hepatic biliary system and can be identified readily as a unique neoplasm. Broader acceptance of BT-IPMN as a unique neoplasm may lead to a better understanding of the pathogenesis of biliary malignancies.
背景
尽管报道的病例越来越多，但胆管内乳头状黏液性肿瘤（BT-IPMN）尚未被认为是一种独特的肿瘤。本研究的目的是在一系列大型切除的胆道肿瘤中确定 BT-IPMN 的存在。
方法
从 1994 年 5 月至 2006 年 12 月，通过回顾所有切除的胆管癌和其他胆道肿瘤的病理标本，当病理报告中提到囊性、乳头状或黏液性特征时，确定 BT-IPMN 病例。
结果
使用 IPMN 的严格组织病理学标准，在 253 个标本中确定了 23 个（9%）BT-IPMN。最常见的首发症状是腹部不适，15 例患者（65%）存在该症状。只有一份原始手术病理报告使用了 IPMN 一词；16 份（70%）使用了囊性、黏液性和/或乳头状术语。BT-IPMN 孤立于非肝门外胆管 12 例（52%），肝内胆管 6 例（26%），肝门外胆管 5 例（22%）。19 例（83%）患者发现与 BT-IPMN 相关的癌；切除后 5 年生存率为 38%。
结论
BT-IPMN 发生于肝内外胆管系统的各个部位，可作为一种独特的肿瘤轻易识别。更广泛地接受 BT-IPMN 作为一种独特的肿瘤，可能会更好地理解胆道恶性肿瘤的发病机制。
Zotero 插件