OBJECTIVES:Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas encompasses a spectrum of neoplasms with both morphological and immunohistochemical variations of mucin glycoproteins. Recently, a consensus nomenclature and criteria were histologically defined for classifying these variants of IPMNs into gastric, intestinal, pancreatobiliary, and oncocytic types. The purpose of this study was to determine associations between the histological types and clinicopathological features in patients with IPMN. METHODS:Sixty-one patients with IPMN operated upon at Tohoku University Hospital between 1988 and 2006 were retrospectively analyzed. RESULTS:Our series included 27 gastric-, 29 intestinal-, 4 pancreatobiliary-, and 1 oncocytic-type IPMNs. Statistically, the types of IPMN were significantly associated with the histological diagnoses, macroscopic types, and survival of the patients. Characteristically, the gastric-type IPMNs were likely to be diagnosed as benign, to be confined to branch ducts, and to have fair prognoses. On the other hand, the intestinal-type IPMNs were likely to be diagnosed as malignant, occupy the main duct, and have poor prognoses. Because of the small number of pancreatobiliary-type IPMNs and only 1 case of oncocytic-type IPMN, we were unable to determine any of their clinicopathological characteristics in our series. CONCLUSIONS:Evaluation of the histological types of IPMN may help to predict the clinical course of patients with IPMN and to design improved clinical management for these patients.

译文

目的:胰腺导管内乳头状粘液性肿瘤(IPMN)涵盖了一系列黏蛋白糖蛋白的形态学和免疫组化变异的肿瘤。最近,在组织学上定义了共识命名法和标准,以将IPMN的这些变体分类为胃,肠,胰胆管和溶细胞型。这项研究的目的是确定IPMN患者的组织学类型与临床病理特征之间的关联。
方法:回顾性分析1988年至2006年在东北大学医院手术的61例IPMN患者。
结果:我们的系列包括27胃,29肠,4胰胆管和1吞噬型IPMNs。从统计学上讲,IPMN的类型与患者的组织学诊断,宏观类型和生存率显着相关。特征性地,胃型IPMNs可能被诊断为良性,局限于分支导管,并且预后良好。另一方面,肠型IPMN可能被诊断为恶性,占据主导管且预后较差。由于胰胆管型IPMN的数量很少,而仅1例胞浆型IPMN,我们无法确定其在本系列中的任何临床病理特征。
结论:对IPMN的组织学类型进行评估可能有助于预测IPMN患者的临床病程,并为这些患者设计更好的临床治疗方法。

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