Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University Medical Center, Indianapolis, 46202, USA.
Clin Gastroenterol Hepatol. 2011 Aug;9(8):635-48. doi: 10.1016/j.cgh.2011.03.005. Epub 2011 Mar 11.
Cystic pancreatic tumors (CPTs) have more frequently been identified in the last decade because of increased use of cross-sectional abdominal imaging. Although serous CPTs follow an indolent course and do not necessarily require surgical resection or long-term follow-up, mucinous CPTs (mucinous cystic neoplasms and intraductal papillary mucinous neoplasms) have a greater risk for malignancy. Although most CPTs are initially detected with imaging modalities such as computed tomography or magnetic resonance imaging, these tests alone rarely permit an accurate clinical diagnosis. Endoscopic ultrasound and endoscopic ultrasound-guided, fine-needle aspiration allow real-time examination and biopsy analysis of CPTs, which increases diagnostic accuracy because cytopathology features and tumor markers in cyst fluid can be analyzed. Management of patients with mucinous CPTs by surgery or imaging surveillance is controversial, partially because of limited information about disease progression and the complexities of surgical resection. We review approaches to diagnosis and management of common CPTs.
在过去十年中，由于腹部横断面成像的广泛应用，囊性胰腺肿瘤（CPTs）的检出率越来越高。虽然浆液性 CPT 呈惰性发展，不一定需要手术切除或长期随访，但黏液性 CPT（黏液性囊腺瘤和导管内乳头状黏液性肿瘤）具有更高的恶性风险。尽管大多数 CPT 最初通过计算机断层扫描或磁共振成像等影像学方法检测到，但这些检查单独很少能做出准确的临床诊断。内镜超声和内镜超声引导下细针抽吸术可实时检查和分析 CPT，从而提高诊断准确性，因为可以分析囊液中的细胞学特征和肿瘤标志物。黏液性 CPT 的手术或影像学监测管理存在争议，部分原因是关于疾病进展的信息有限，以及手术切除的复杂性。我们回顾了常见 CPT 的诊断和管理方法。
