Moris Maria, Raimondo Massimo, Woodward Timothy A, Skinner Verna J, Arcidiacono Paolo G, Petrone Maria C, De Angelis Claudio, Manfrè Selene, Carrara Silvia, Jovani Manol, Fusaroli Pietro, Wallace Michael B
From the *Department of Gastroenterology and †Clinical Studies Unit, Mayo Clinic, Jacksonville, FL; ‡Department of Gastroenterology, San Raffaele Scientific Institute, Milan; §Department of Gastroenterology, Azienda Universitario-Ospedaliera San Giovanni Battista, Turin; ∥Department of Gastroenterology, Humanitas Research Hospital, Milan; and ¶Department of Gastroenterology, University of Bologna/Hospital of Imola, Italy.
Pancreas. 2017 Mar;46(3):306-310. doi: 10.1097/MPA.0000000000000750.
The aim of this study was to analyze the outcomes of a long-term intraductal papillary mucinous neoplasm (IPMN) registry and evaluate new guidelines.
A prospectively maintained IPMN registry involving 6 centers in Europe and the United States was used to collect the data. Patients with more than 1-year follow-up and no malignancy diagnosed within the first 3 months of surveillance were included.
From 1999 to 2014, 620 patients were included. The median follow-up time was 3 years. Thirty-seven (6%) patients developed malignancy with a median time from IPMN diagnosis to malignancy of 10.3 months. The 1-, 5-, and 10-year actuarial rates of disease-free survival were 97%, 93%, and 92% respectively. Four hundred thirty-one patients met criteria for low-risk branch duct IPMN consisting of cyst size less than 3 cm, with no solid component or main duct dilation. Eight malignancies were diagnosed in this subgroup, all of them within the first 5 years. From this subcohort, 112 patients had a follow-up time of more than 5 years, and no malignancy was diagnosed.
In IPMN lesions with low-risk features at baseline, the risk of progression to malignancy after the first 5 years of follow-up was minimal. Furthermore, the main cyst characteristics remained unchanged during their surveillance.
本研究旨在分析长期导管内乳头状黏液性肿瘤（IPMN）登记处的结果并评估新指南。
使用一个前瞻性维护的IPMN登记处，该登记处涉及欧洲和美国的6个中心，用于收集数据。纳入随访时间超过1年且在监测的前3个月内未诊断出恶性肿瘤的患者。
1999年至2014年，纳入620例患者。中位随访时间为3年。37例（6%）患者发生恶性肿瘤，从IPMN诊断到恶性肿瘤的中位时间为10.3个月。1年、5年和10年的无病生存率精算率分别为97%、93%和92%。431例患者符合低风险分支导管IPMN标准，包括囊肿大小小于3 cm，无实性成分或主胰管扩张。该亚组诊断出8例恶性肿瘤，均在最初5年内。在这个亚队列中，112例患者的随访时间超过5年，未诊断出恶性肿瘤。
在基线具有低风险特征的IPMN病变中，随访5年后进展为恶性肿瘤的风险极小。此外，在监测期间，主要囊肿特征保持不变。
