Hu Feixiang, Hu Yue, Wang Dan, Ma Xiaowen, Yue Yali, Tang Wei, Liu Wei, Wu Puye, Peng Weijun, Tong Tong
Department of Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Hefei Cancer Hospital, Chinese Academy of Sciences (CAS), Hefei, China.
Front Oncol. 2022 Mar 1;12:860740. doi: 10.3389/fonc.2022.860740. eCollection 2022.
Although the probability of pancreatic cystic neoplasms (PCNs) being detected is raising year by year, their differential diagnosis and individualized treatment are still a challenge in clinical work. PCNs are tumors containing cystic components with different biological behaviors, and their clinical manifestations, epidemiology, imaging features, and malignant risks are different. Some are benign [e.g., serous cystic neoplasms (SCNs)], with a barely possible that turning into malignant, while others display a low or higher malignant risk [e.g., solid pseudopapillary neoplasms (SPNs), intraductal papillary mucinous neoplasms (IPMNs), and mucinous cystic neoplasms (MCNs)]. PCN management should concentrate on preventing the progression of malignant tumors while preventing complications caused by unnecessary surgical intervention. Clinically, various advanced imaging equipment are usually combined to obtain a more reliable preoperative diagnosis. The challenge for clinicians and radiologists is how to accurately diagnose PCNs before surgery so that corresponding surgical methods and follow-up strategies can be developed or not, as appropriate. The objective of this review is to sum up the clinical features, imaging findings and management of the most common PCNs according to the classic literature and latest guidelines.
尽管胰腺囊性肿瘤(PCNs)的检出概率逐年上升,但其鉴别诊断和个体化治疗在临床工作中仍是一项挑战。PCNs是包含具有不同生物学行为的囊性成分的肿瘤,它们的临床表现、流行病学、影像学特征和恶性风险各不相同。有些是良性的[如浆液性囊性肿瘤(SCNs)],几乎不可能恶变,而其他一些则显示出低或高的恶性风险[如实性假乳头状肿瘤(SPNs)、导管内乳头状黏液性肿瘤(IPMNs)和黏液性囊性肿瘤(MCNs)]。PCN的管理应侧重于预防恶性肿瘤的进展,同时预防不必要的手术干预引起的并发症。临床上,通常联合使用各种先进的成像设备以获得更可靠的术前诊断。临床医生和放射科医生面临的挑战是如何在手术前准确诊断PCNs,以便酌情制定相应的手术方法和随访策略。本综述的目的是根据经典文献和最新指南总结最常见PCNs的临床特征、影像学表现及管理。