Sereni Elisabetta, Luchini Claudio, Salvia Roberto, Pea Antonio
Unit of General and Pancreatic Surgery, University of Verona Hospital Trust, Verona, Italy.
Department of Pathology, University of Verona Hospital Trust, Verona, Italy.
Chin Clin Oncol. 2019 Apr;8(2):21. doi: 10.21037/cco.2019.04.03.
Intraductal papillary mucinous neoplasms (IPMN) are pancreatic cystic lesions that can progress to invasive carcinoma. Consensus guidelines indicate surgery for IPMN at high risk of malignant progression, as assessed by specific radiological and clinical criteria, whereas an active radiological surveillance is recommended for IPMN at low risk of malignancy. The management of IPMN is further complicated by the risk of developing a distinct new cyst or a ductal adenocarcinoma in the remnant pancreas, either synchronously or metachronously. Several studies therefore investigated local progression in the remnant pancreas following partial pancreatic resection for IPMN and whether an unstable epithelium at risk for malignant degeneration may exist. Understanding the biological mechanisms behind progression of IPMN will help in identifying patients that would benefit from the resection of the entire pancreas.
导管内乳头状黏液性肿瘤（IPMN）是一种胰腺囊性病变，可进展为浸润性癌。共识指南指出，根据特定的影像学和临床标准评估，具有恶性进展高风险的IPMN需进行手术，而对于恶性风险低的IPMN，建议进行积极的影像学监测。IPMN的管理因在残余胰腺中同步或异时发生新的独特囊肿或导管腺癌的风险而进一步复杂化。因此，多项研究调查了IPMN行部分胰腺切除术后残余胰腺的局部进展情况，以及是否存在有恶性退变风险的不稳定上皮。了解IPMN进展背后的生物学机制将有助于识别可从全胰腺切除术中获益的患者。
