Kubota Keiichi, Nakanuma Yasuni, Kondo Fukuo, Hachiya Hiroyuki, Miyazaki Masaru, Nagino Masato, Yamamoto Masakazu, Isayama Hiroyuki, Tabata Masami, Kinoshita Hisafumi, Kamisawa Terumi, Inui Kazuo
Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi 321-0283, Japan.
J Hepatobiliary Pancreat Sci. 2014 Mar;21(3):176-85. doi: 10.1002/jhbp.23. Epub 2013 Aug 1.
The aim of this study was to determine the clinicopathological features and surgical outcomes of mucinous cystic neoplasm of the liver (MCN) and mucin-producing intraductal papillary neoplasm of the intrahepatic bile duct (M-IPNB).
We performed a multi-institutional, retrospective study of patients with MCN or M-IPNB pathologically defined by the presence or absence of an ovarian-like stroma.
The M-IPNB and MCN were diagnosed in 119 and nine patients, respectively. MCN was observed in female patients, while M-IPNB produced symptoms of cholangitis. M-IPNBs were classed as low or intermediate grade in 53 cases, high grade in 23 and invasive carcinoma in 43. Fifty-one of the M-IPNBs were the pancreatobiliary type (PT), 33 were the intestinal type (IT), 23 were the oncocytic type (OT), and 12 were the gastric type (GT). The 1-, 5- and 10-year survival rates for the 105 patients with M-IPNB were 96%, 84% and 81%, respectively, while the 5-year survival rate for patients with MCN was 100%. OT and GT M-IPNB had better 10-year survival rates than PT and IT M-IPNB.
Although MCN has different features from M-IPNB, both diseases have a good prognosis after resection. The cellular type of M-IPNB appears to predict outcome.
本研究旨在确定肝黏液性囊性肿瘤(MCN)和肝内胆管黏液分泌性导管内乳头状肿瘤(M-IPNB)的临床病理特征及手术结果。
我们对根据是否存在卵巢样间质病理定义为MCN或M-IPNB的患者进行了一项多机构回顾性研究。
分别在119例和9例患者中诊断出M-IPNB和MCN。MCN见于女性患者,而M-IPNB出现胆管炎症状。53例M-IPNB分类为低级别或中级别,23例为高级别,43例为浸润性癌。51例M-IPNB为胰胆管型(PT),33例为肠型(IT),23例为嗜酸性细胞型(OT),12例为胃型(GT)。105例M-IPNB患者的1年、5年和10年生存率分别为96%、84%和81%,而MCN患者的5年生存率为100%。OT和GT M-IPNB的10年生存率优于PT和IT M-IPNB。
虽然MCN与M-IPNB具有不同特征,但两种疾病切除后预后均良好。M-IPNB的细胞类型似乎可预测预后。