Rong Yefei, Wang Dansong, Xu Chen, Ji Yuan, Jin Dayong, Wu Wenchuan, Xu Xuefeng, Kuang Tiantao, Lou Wenhui
Department of Pancreatic Surgery Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China.
Medicine (Baltimore). 2017 Apr;96(15):e6599. doi: 10.1097/MD.0000000000006599.
We sought to retrospectively analyze the outcomes of patients with intraductal papillary mucinous neoplasm (IPMN) at our pancreatic surgery center, and to evaluate the prognostic value of histological subtype.The clinical data of 121 IPMNs treated in our center between 2005 and 2014 were retrospectively analyzed. Pathological slides were thoroughly reviewed by 2 specialized pathologists.Of the 121 patients, 48, 57, and 16 had main-duct, branch-duct, and mixed type IPMNs, respectively. Forty-one patients had invasive IPMNs. Histological subtypes consisted of 35 intestinal (28.9%), 56 gastric (46.3%), 29 pancreatobiliary (24.0%), and 1 oncocytic type (0.8%). Histological subtype was associated with radiological type, T stage, and degree of dysplasia (P < .05). No significant difference in overall survival was observed among the 4 histological subtypes, regardless of whether we considered all IPMNs (P = .106), or invasive IPMNs only (P = .828). However, the overall survival was associated with radiological type, T stage, degree of dysplasia, lymph-node status, and nerve invasion. For invasive IPMNs, the overall survival was associated with nerve invasion and lymph-node status; however, the association between nerve invasion and overall survival lost statistical significance after multivariate analysis.Histological subtype had limited prognostic value in patients with IPMNs, and the main prognostic factor for patients with invasive IPMNs was the lymph-node status.
我们试图对我院胰腺外科中心导管内乳头状黏液性肿瘤(IPMN)患者的治疗结果进行回顾性分析,并评估组织学亚型的预后价值。对2005年至2014年期间在我院接受治疗的121例IPMN患者的临床资料进行回顾性分析。由2名专业病理学家对病理切片进行全面复查。121例患者中,分别有48例、57例和16例为导管内乳头状黏液性肿瘤的主胰管型、分支胰管型和混合型。41例患者为浸润性IPMN。组织学亚型包括35例肠型(28.9%)、56例胃型(46.3%)、29例胰胆管型(24.0%)和1例嗜酸细胞型(0.8%)。组织学亚型与放射学类型、T分期和发育异常程度相关(P<0.05)。在4种组织学亚型中,无论是否考虑所有IPMN患者(P=0.106)或仅考虑浸润性IPMN患者(P=0.828),总生存率均无显著差异。然而,总生存率与放射学类型、T分期、发育异常程度、淋巴结状态和神经侵犯相关。对于浸润性IPMN,总生存率与神经侵犯和淋巴结状态相关;然而,多因素分析后,神经侵犯与总生存率之间的相关性失去统计学意义。组织学亚型对IPMN患者的预后价值有限,浸润性IPMN患者的主要预后因素是淋巴结状态。