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目的总结胰腺导管内乳头状黏液性肿瘤(IPMNs)的研究进展。方法查阅近年来国内外有关IPMNs的研究文献并做综述。结果 IPMNs根据肿瘤累及部位可分为主胰管型、分支胰管型和混合型,根据组织学特点又可分为肠型、胰胆管上皮型、胃型及嗜酸细胞型;其病理特征及临床表现多样;多种影像学检查,包括内镜逆行胆胰管造影(ERCP)、超声内镜(EUS)、CT、MRI联合磁共振胆胰管水成像(MRCP)等,可显示IPMNs的形态及功能特征,并能进行肿瘤恶性风险度的预测;在IPMNs的发生发展过程中部分基因(包括KRAS、BRAF、GNAS等基因)的功能逐渐被证实。结论 IPMNs是一种在临床病理、影像学表现及分子生物学改变方面与胰腺其他肿瘤差异较大的病变,如何将上述三者联系起来,有待进一步研究。
Objective To summarize the research progress of intraductal papillary mucinous neoplasms (IPMNs). Methods To review the literatures about IPMNs at home and abroad in recent years and make a summary. Results IPMNs could be divided into primary pancreatic duct type, branch pancreatic duct type and mixed type according to tumor involvement sites. According to the histological features, IPMNs could be divided into intestinal type, pancreatic duct epithelial type, gastric type and eosinophilic type. The pathological features and Various clinical manifestations; a variety of imaging studies, including endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography (EUS), CT, MRI combined with MRCP, etc., can display the morphology of IPMNs And functional characteristics, and can predict the malignant tumor risk. The function of some genes (including KRAS, BRAF, GNAS and other genes) has been gradually confirmed during the development of IPMNs. Conclusions IPMNs are a kind of pathological changes which have great difference from other pancreatic tumors in clinical pathology, imaging findings and molecular biology. How to link the above three issues needs further study.