Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, 100730, China.
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, 100730, China.
Pancreatology. 2019 Sep;19(6):858-865. doi: 10.1016/j.pan.2019.07.040. Epub 2019 Jul 27.
Intraductal oncocytic papillary neoplasm of the pancreas (IOPN-P) is a rare subtype of intraductal papillary mucinous neoplasm (IPMN). This study was performed to summarize the clinicopathological features and management of IOPN-P.
English-language articles were searched from MEDLINE and EMBASE from the first report of IOPN-P in 1996 until 1 May 2019 following the methodology in the PRISMA guidelines.
In total, 66 patients from 24 full articles were included in the final data analysis. The patients' average age was 61 years, and the male/female ratio was 1. Most lesions were large (average size, 5.50 cm), located in the pancreatic head, and found either incidentally or by uncharacteristic abdominal symptoms. IOPN-P was usually a cystic and solid lesion with or without mural nodules on radiological examination. A definitive diagnosis was often acquired from fine needle aspiration biopsy or postoperative pathology. All tumors were diagnosed as carcinoma in situ or minimally invasive carcinoma, necessitating surgical resection. The prognosis of IOPN-P was better than that of other IPMN subtypes, even when metastasis occurred. Recurrence after surgical resection of IOPN-P was rare.
IOPN-P is rare among IPMN subtypes with unique pathological characteristics. Because of the nontypical symptoms and radiological findings, a definitive preoperative diagnosis usually depends on multimodal examinations. Management and surveillance of IOPN-P after surgical resection should be differentiated from those of other pancreatic benign cystic lesions because of its relative malignancy, but IOPN-P should also be differentiated from other IPMN subtypes and malignant cystic tumors because of its favorable prognosis.
胰腺导管内嗜酸细胞性乳头状肿瘤（IOPN-P）是一种罕见的胰腺导管内乳头状黏液性肿瘤（IPMN）亚型。本研究旨在总结 IOPN-P 的临床病理特征和处理方法。
按照 PRISMA 指南的方法，从 1996 年首次报道 IOPN-P 以来，在 MEDLINE 和 EMBASE 上搜索英文文献。
共有 24 篇全文的 66 例患者纳入最终数据分析。患者的平均年龄为 61 岁，男女比例为 1:1。大多数病变较大（平均大小为 5.50cm），位于胰头部，或偶然发现，或因非特征性腹部症状发现。IOPN-P 在影像学检查上通常为囊实性病变，伴有或不伴有壁结节。明确诊断通常来自细针抽吸活检或术后病理。所有肿瘤均诊断为原位癌或微浸润癌，需要手术切除。与其他 IPMN 亚型相比，即使发生转移，IOPN-P 的预后也较好。IOPN-P 手术后复发罕见。
IOPN-P 在 IPMN 亚型中较为罕见，具有独特的病理特征。由于非典型的症状和影像学表现，术前明确诊断通常依赖于多模态检查。由于其相对恶性，手术后对 IOPN-P 的管理和监测应与其他胰腺良性囊性病变区分开来，但由于其预后良好，也应与其他 IPMN 亚型和恶性囊性肿瘤区分开来。
