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揭开谜团:胰腺实性假乳头状瘤的全面综述

Unraveling the enigma: A comprehensive review of solid pseudopapillary tumor of the pancreas.

作者信息

Xu Ye-Cheng, Fu De-Liang, Yang Feng

机构信息

Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Fudan University, Shanghai 200040, China.

出版信息

World J Gastrointest Oncol. 2024 Mar 15;16(3):614-629. doi: 10.4251/wjgo.v16.i3.614.

Abstract

Solid pseudopapillary tumor of the pancreas (SPTP) is a rare neoplasm predominantly observed in young females. Pathologically, CTNNB1 mutations, β-catenin nuclear accumulation, and subsequent Wnt-signaling pathway activation are the leading molecular features. Accurate preoperative diagnosis often relies on imaging techniques and endoscopic biopsies. Surgical resection remains the mainstay treatment. Risk models, such as the Fudan Prognostic Index, show promise as predictive tools for assessing the prognosis of SPTP. Establishing three types of metachronous liver metastasis can be beneficial in tailoring individualized treatment and follow-up strategies. Despite advancements, challenges persist in understanding its etiology, establishing standardized treatments for unresectable or metastatic diseases, and developing a widely recognized grading system. This comprehensive review aims to elucidate the enigma by consolidating current knowledge on the epidemiology, clinical presentation, pathology, molecular characteristics, diagnostic methods, treatment options, and prognostic factors.

摘要

胰腺实性假乳头状瘤(SPTP)是一种罕见的肿瘤,主要见于年轻女性。病理上,CTNNB1突变、β-连环蛋白核积聚以及随后的Wnt信号通路激活是主要的分子特征。准确的术前诊断通常依赖于影像学技术和内镜活检。手术切除仍然是主要的治疗方法。风险模型,如复旦预后指数,有望作为评估SPTP预后的预测工具。建立三种类型的异时性肝转移对于制定个体化治疗和随访策略可能有益。尽管取得了进展,但在了解其病因、建立不可切除或转移性疾病的标准化治疗方法以及开发广泛认可的分级系统方面仍存在挑战。这篇综述旨在通过整合目前关于流行病学、临床表现、病理学、分子特征、诊断方法、治疗选择和预后因素的知识来阐明这一谜团。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c2a/10989376/9f7b7f4d5306/WJGO-16-614-g001.jpg

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