Servicio de Cirugía de Páncreas, Bazo y Retroperitoneo, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru.
Servicio de Cirugía de Páncreas, Bazo y Retroperitoneo, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru.
Cir Esp (Engl Ed). 2023 Nov;101(11):736-745. doi: 10.1016/j.cireng.2023.01.002. Epub 2023 Jan 27.
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas can progress from low-grade dysplasia to high-grade dysplasia and invasive carcinoma.
In this single-center retrospective series, we analyze the clinicopathological features and long-term follow up of patients who underwent pancreatic resection for IPMN, from January 2009 to December 2019.
31 patients were diagnosed with IPMN: 9 males and 22 females. Mean age was 67 years. Twenty-seven patients (87%) were symptomatic. Seven patients had main duct IPMN, 11 branch-type IPMN and 13 mixed-type IPMN. High-risk stigmata were found in 20 patients (64.5%) and worrisome features in 10 patients (32.2%). Thirteen patients (41.9%) had an associated invasive carcinoma, 4 (12.9%) high-grade dysplasia and 14 (45.2%) low-grade dysplasia. The follow-up was from 2 to 12 years. Median survival for patients with IPMN and associated invasive carcinoma was 45.8 months, and disease-free survival was 40.8 months.
IPMN had a higher prevalence in females, mostly symptomatic and high incidence of associated invasive carcinoma with branch type. The 5-year survival was good even with associated invasive carcinoma.
胰腺内导管乳头状黏液性肿瘤(IPMN)可由低级别异型增生进展为高级别异型增生和浸润性癌。
在这项单中心回顾性系列研究中,我们分析了 2009 年 1 月至 2019 年 12 月期间因 IPMN 接受胰腺切除术的患者的临床病理特征和长期随访结果。
31 例患者被诊断为 IPMN:9 例男性,22 例女性。平均年龄为 67 岁。27 例(87%)有症状。7 例为主胰管型 IPMN,11 例为分支型 IPMN,13 例为混合型 IPMN。20 例(64.5%)发现高危特征,10 例(32.2%)存在令人担忧的特征。13 例(41.9%)患者伴有浸润性癌,4 例(12.9%)高级别异型增生,14 例(45.2%)低级别异型增生。随访时间为 2 至 12 年。伴有浸润性癌的 IPMN 患者的中位生存时间为 45.8 个月,无疾病生存时间为 40.8 个月。
女性 IPMN 患病率较高,多为有症状,分支型伴发浸润性癌的发生率较高。即使伴有浸润性癌,5 年生存率也较好。