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胰腺囊肿与指南

Pancreatic Cysts and Guidelines.

作者信息

Farrell James J

机构信息

Yale Center for Pancreatic Diseases, Interventional Endoscopy, Yale School of Medicine, New Haven, CT, USA.

Section of Digestive Diseases, Yale University School of Medicine, LMP 1080, 15 York Street, New Haven, CT, 06510-3221, USA.

出版信息

Dig Dis Sci. 2017 Jul;62(7):1827-1839. doi: 10.1007/s10620-017-4571-5. Epub 2017 May 20.

Abstract

Pancreatic cysts, especially incidental asymptomatic ones seen on noninvasive imaging such as CT or MR imaging, remain a clinical challenge. The etiology of such cysts may range from benign cysts without any malignant potential such as pancreatic pseudocysts and serous cystadenomas to premalignant or frankly malignant cysts such as mucinous cystic neoplasms, intraductal papillary mucinous neoplasms, cystic degeneration associated with solid tumors such as pancreatic ductal adenocarcinoma or pancreatic endocrine neoplasms, and solid pseudopapillary neoplasms. The clinical challenge in 2017 is to accurately preoperatively diagnose them and their malignant potential before deciding about surgery, surveillance or doing nothing. This review will focus on the currently available clinical guidelines for doing so.

摘要

胰腺囊肿,尤其是在CT或磁共振成像等无创性检查中偶然发现的无症状囊肿,仍然是一个临床难题。此类囊肿的病因范围广泛,从无任何恶性潜能的良性囊肿(如胰腺假性囊肿和浆液性囊腺瘤)到癌前或明显恶性的囊肿(如黏液性囊性肿瘤、导管内乳头状黏液性肿瘤、与实性肿瘤(如胰腺导管腺癌或胰腺内分泌肿瘤)相关的囊性变,以及实性假乳头状肿瘤)。2017年的临床挑战在于,在决定进行手术、监测或不采取任何措施之前,准确地在术前诊断这些囊肿及其恶性潜能。本综述将聚焦于目前可用的相关临床指南。

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