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通过福冈共识与欧洲胰腺囊性肿瘤循证指南对比来指导导管内乳头状黏液性肿瘤的管理——一项对两个欧洲中心的研究

Navigating Intraductal Papillary Mucinous Neoplasm Management through Fukuoka Consensus vs. European Evidence-Based Guidelines on Pancreatic Cystic Neoplasms-A Study on Two European Centers.

作者信息

Djordjevic Vladimir, Knezevic Djordje, Trotovsek Blaz, Tomazic Ales, Petric Miha, Hadzialjevic Benjamin, Grubor Nikica, Djokic Mihajlo

机构信息

First Surgical Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia.

University Medical Center Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia.

出版信息

Cancers (Basel). 2024 Jun 6;16(11):2156. doi: 10.3390/cancers16112156.

DOI:10.3390/cancers16112156
PMID:38893274
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11171892/
Abstract

This study addresses the critical need for the accurate diagnosis and management of intraductal papillary mucinous neoplasms (IPMNs), which are pancreatic cystic neoplasm types holding a substantial potential for malignancy. It evaluates the diagnostic effectiveness of the Fukuoka consensus guidelines and the European evidence-based guidelines in detecting high-grade dysplasia/invasive carcinoma in IPMNs, utilizing a retrospective analysis of 113 patients from two European medical centers. The methods include a comparative analysis of clinical, radiological, and endoscopic ultrasonography data, alongside an assessment of guideline-driven diagnostic performance. The results demonstrate that both guidelines offer similar accuracy in identifying severe disease stages in IPMNs, with certain clinical markers-such as jaundice, solid mass presence, and an increase in CA 19-9 levels-being pivotal in predicting the need for surgical intervention. This study concludes that while both guidelines provide valuable frameworks for IPMN management, there is an inherent need for further research to refine these protocols and improve patient-specific treatment strategies. This research contributes to the ongoing discourse on optimizing diagnostic and treatment paradigms for pancreatic cystic neoplasms, aiming to enhance clinical outcomes and patient care in this challenging medical field.

摘要

本研究满足了对导管内乳头状黏液性肿瘤(IPMN)进行准确诊断和管理的迫切需求,IPMN是一类具有显著恶性潜能的胰腺囊性肿瘤。该研究利用对来自两个欧洲医疗中心的113例患者的回顾性分析,评估了福冈共识指南和欧洲循证指南在检测IPMN中的高级别异型增生/浸润性癌方面的诊断有效性。方法包括对临床、放射学和内镜超声数据的比较分析,以及对指南驱动的诊断性能的评估。结果表明,这两种指南在识别IPMN的严重疾病阶段方面具有相似的准确性,某些临床指标——如黄疸、实性肿块的存在以及CA 19-9水平的升高——在预测手术干预需求方面至关重要。本研究得出结论,虽然这两种指南都为IPMN的管理提供了有价值的框架,但仍有内在需求进行进一步研究以完善这些方案并改进针对患者的治疗策略。这项研究有助于正在进行的关于优化胰腺囊性肿瘤诊断和治疗模式的讨论,旨在改善这一具有挑战性的医学领域的临床结果和患者护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c614/11171892/171650bab777/cancers-16-02156-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c614/11171892/171650bab777/cancers-16-02156-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c614/11171892/171650bab777/cancers-16-02156-g001.jpg

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本文引用的文献

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Pancreatology. 2024 Mar;24(2):255-270. doi: 10.1016/j.pan.2023.12.009. Epub 2023 Dec 28.
2
Association of high-risk stigmata and worrisome features with advanced neoplasia in intraductal papillary mucinous neoplasms (IPMN): A systematic review.高危特征和令人担忧的特征与胰管内乳头状黏液性肿瘤(IPMN)中的高级别肿瘤的相关性:系统综述。
Pancreatology. 2024 Feb;24(1):48-61. doi: 10.1016/j.pan.2023.12.002. Epub 2023 Dec 7.
3
The effectiveness of endoscopic ultrasonography findings to distinguish benign and malignant intraductal papillary mucinous neoplasm.
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Surg Endosc. 2023 Jun;37(6):4681-4688. doi: 10.1007/s00464-022-09752-3. Epub 2023 Mar 7.
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Diagnostics (Basel). 2023 Feb 16;13(4):749. doi: 10.3390/diagnostics13040749.
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