The clinicopathologic features of intraductal papillary mucinous neoplasms of the pancreas
Tóm tắt
Since first described in 1982, intraductal papillary mucinous neoplasm (IPMN) has been the preferred term to describe the proliferation of the pancreatic ductal epithelium. It is totally different from pancreatic carcinoma in epidemiology, histology, pathology and prognosis. According to the site of involvement, IPMNs are classified into three categories, i.e. main duct type, branch duct type, and combined type. Most branch duct IPMNs are benign, whereas the other two types are often malignant. A large branch duct IPMN and marked dilation of the main pancreatic duct indicate the presence of adenoma at least. The additional existence of large mural nodules increases the possibility of malignancy in all types. The prognosis is more favorable after complete resection of benign and non-invasive malignant IPMNs. Malignant IPMNs that become more aggressive after parenchymal invasion necessitate adequate lymph node dissection. On the other hand, asymptomatic branch duct IPMNs without mural nodules can be observed without the need for resection for a considerable period of time. Our review addresses available data, current understanding, controversy, and future directions about IPMNs.
Tài liệu tham khảo
Furuta K, Watanabe H, Ikeda S. Differences between solid and duct-ectatic types of pancreatic ductal carcinomas. Cancer, 1992, 69(6): 1327–1333
Kloeppel G, Solcia E, Longnecker D S, Capella C, Sobin L H. Histological typing of tumors of the exocrine pancreas. In: World Health Organization International Histological Classification of Tumors. 2nd ed. Berlin: Springer, 1996: 11–20
Ohhashi K, Murakami Y, Takekoshi T. Four cases of “mucinproducing” cancer of the pancreas on specific findings of the papilla Vater. Prog Dig Endosc, 1982, 20: 348–351
Sugiyama M, Atomi Y. Intraductal papillary mucinous tumors of the pancreas: imaging studies and treatment strategies. Ann Surg, 1998, 228(5): 685–691
Hruban R H, Takaori K, Klimstra D S, Adsay N V, Albores-Saavedra J, Biankin A V, Biankin S A, Compton C, Fukushima N, Furukawa T, Goggins M, Kato Y, Kloppel G, Longnecker D S, Luttges J, Maitra A, Offerhaus G J, Shimizu M, Yonezawa S. An illustrated consensus on the classification of pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms. Am J Surg Pathol, 2004, 28(8): 977–987
Sohn T A, Yeo C J, Cameron J L, Iacobuzio-Donahue C A, Hruban R H, Lillemoe K D. Intraductal papillary mucinous neoplasms of the pancreas: An increasingly recognized clinicopathologic entity. Ann Surg, 2001, 234(3): 313–321
Falconi M, Salvia R, Bassi C, Zamboni G, Talamini G, Pederzoli P. Clinico-pathological features and treatment of intraductal papillary mucinous tumor of the pancreas. Br J Surg, 2001, 88(3): 376–381
Chari S T, Yadav D, Smyrk T C, DiMagno E P, Miller L J, Raimondo M, Clain J E, Norton I A, Pearson R K, Petersen B T, Wiersema M J, Farnell M B, Sarr M G. Study of recurrence after surgical resection of intraductal papillary mucinous neoplasm of the pancreas. Gastroenterology, 2002, 123(5): 1500–1507
Sohn T A, Yeo C J, Cameron J L, Hruban R H, Fukushima N, Campbell K A, Lillemoe K D. Intraductal papillary mucinous neoplasms of the pancreas: An updated experience. Ann Surg, 2004, 239(6): 788–797
Salvia R, Fernandez-del Castillo C, Bassi C, Thayer S P, Falconi M, Mantovani W, Pederzoli P, Warshaw A L. Main duct intraductal papillary mucinous neoplasms of the pancreas: clinical predictors of malignancy and long-term survival following resection. Ann Surg, 2004, 239(5): 678–685
D’Angelica M, Brennan M F, Suriawinata A A, Klimstra D, Conlon K C. Intraductal papillary mucinous neoplasms of the pancreas: An analysis of clinicopathologic features and outcome. Ann Surg, 2004, 239(3): 400–408
Wada K, Kozarek R A, Traverso L W. Outcomes following resection of invasive and non-invasive intraductal papillary mucinous neoplasms of the pancreas. Am J Surg, 2005, 189(5): 632–636
Sugiyama M, Izumisato Y, Abe N, Masaki T, Mori T, Atomi Y. Predictive factors for malignancy in intraductal papillarymucinous tumours of the pancreas. Br J Surg, 2003, 90(10): 1244–1249
Wiesenauer C A, Schmidt C M, Cummings O W, Yiannoutsos C T, Howard T J, Wiebke E A, Goulet R J Jr, McHenry L, Sherman S, Lehman G A, Cramer H, Madura J A. Preoperative predictors of malignancy in pancreatic intraductal papillary mucinous neoplasms. Arch Surg, 2003, 138(6): 610–617
Visser B C, Muthusamay V R, Mulvihill S J, Coakley F. Diagnostic imaging of cystic pancreatic neoplasms. Surg Oncol, 2004, 13(1): 27–39
Yamaguchi K, Tanaka M. Radiologic imagings of cystic neoplasms of the pancreas. Pancreatology, 2001, 1(6): 633–636
Fukukura Y, Fujiyoshi F, Sasaki M, Ichinari N, Inoue H, Kajiya Y, Nakajo M. HASTE MR cholangiopancreatography in the evaluation of inraductal papillary-mucinous tumors of the pancreas. J Comput Assist Tomogr, 1999, 23(2): 301–305
Albert J, Schilling D, Breer H, Jungius K P, Riemann J F, Adamek H E. Mucinous cystadenomas and intraductal papillary mucinous tumors of the pancreas in magnetic resonance cholangiopancreatography. Endoscopy, 2000, 32(6): 472–476
Irie H, Honda H, Aibe H, Kuroiwa T, Yoshimitsu K, Shinozaki K, Yamaguchi K, Shimada M, Masuda K. MR cholangiopancreatographic differentiation of benign and malignant intraductal mucin-producing tumors of the pancreas. AJR Am J Roentgenol, 2000, 174(5): 1403–1408
Sugiyama M, Abe N, Tokuhara M, Masaki T, Mori T, Takahara T, Hachiya J, Atomi Y. Magnetic resonance cholangio-pancreatography for postoperative follow up of intraductal papillary mucinous tumors of the pancreas. Am J Surg, 2003, 185(3): 251–255
Cellier C, Cuillerier E, Palazzo L, Rickaert F, Flejou J F, Napoleon B, Van Gansbeke D, Bely N, Ponsot P, Partensky C, Cugnenc P H, Barbier J P, Deviere J, Cremer M. Intraductal papillary and mucinous tumors of the pancreas: Accuracy of preoperative computed tomography, endoscopic retrograde pancreatography and endoscopic ultrasonography, and long-term outcome in a large surgical series. Gastrointest Endosc, 1998, 47(1): 42–49
Kubo H, Chijiiwa Y, Akahoshi K, Hamada S, Harada N, Sumii T, Takashima M, Nawata H. Intraductal papillary mucinous tumors of the pancreas: Differential diagnosis between benign and malignant tumors by endoscopic ultrasonography. Am J Gastroenterol, 2001, 96(5): 1429–1434
Tanaka M, Kobayashi K, Mizumoto K, Yamaguchi K. Clinical aspects of intraductal papillary mucinous neoplasm of the pancreas. J Gastroenterol, 2005, 40(7): 669–675
Traverso L W, Peralta E A, Ryan J A, Kozarek R A. Intraductal neoplasms of the pancreas. Am J Surg, 1998, 175(5): 426–432
Cuillerier E, Cellier C, Palazzo L, Deviere J, Wind P, Rickaert F, Cugnenc P H, Cremer M, Barbier J P. Outcome after surgical resection of intraductal papillary and mucinous tumors of the pancreas. Am J Gastroenterol, 2000, 95(2): 441–445
Gigot J F, Deprez P, Sempoux C, Descamps C, Metairie S, Glineur D, Gianello P. Surgical management of intraductal papillary mucinous tumors of the pancreas: The role of routine frozen section of the surgical margin, intra-operative endoscopic staged biopsies of the Wirsung duct, and pancreaticogastric anastomosis. Arch Surg, 2001, 136(11): 1256–1262
Maire F, Hammel P, Terris B, Paye F, Scoazec J Y, Cellier C, Barthet M, O’Toole D, Rufat P, Partensky C, Cuillerier E, Levy P, Belghiti J, Ruszniewski P. Prognosis of malignant intraductal papillary mucinous tumours of the pancreas after surgical resection: Comparison with pancreatic ductal adenocarcinoma. Gut, 2002, 51(5): 717–722
Adsay N V, Conlon K C, Zee S Y, Brennan M F, Klimstra D S. Intraductal papillary-mucinous neoplasms of the pancreas: An analysis of in situ and invasive carcinomas in 28 patients. Cancer, 2002, 94(1): 62–77
Kimura W, Sasahira N, Yoshikawa T, Muto T, Makuuchi M. Duct-ectatic type of mucin producing tumor of the pancreas-new concept of pancreatic neoplasia. Hepatogastroenterology, 1996, 43(9): 692–709
Sugiyama M, Atomi Y, Kuroda A. Two types of mucin-producing cystic tumors of the pancreas: Diagnosis and treatment. Surgery, 1997, 122(3): 617–625
Hatori T, Imaizumi T, Harada N, Fukuda N, Onizawa S, Takasaki K. Surgical treatment of branch type IPMT of the pancreas-based on the morphology of the pancreatic duct and the location of the tumor. Tan to Sui (Biliary Tract and Pancreas), 2002, 23: 1021–1028 (in Japanese)
Seki M, Yanagisawa A, Ohta H, Ninomiya Y, Sakamoto Y, Yamamoto J, Yamaguchi T, Ninomiya E, Takano K, Aruga A, Yamada K, Sasaki K, Kato Y. Surgical treatment of intraductal papillarymucinous tumor (IPMT) of the pancreas: Operative indications based on surgico-pathologic study focusing on invasive carcinoma derived from IPMT. J Hepatobiliary Pancreat Surg, 2003, 10(2): 147–155
Kaneko T, Nakao A, Inoue S, Sugimoto H, Hatsuno T, Ito A, Hirooka Y, Nagasaka T, Nakashima N. Intraoperative ultrasonography by high-resolution annular array transducer for intraductal papillary mucinous tumors of the pancreas. Surgery, 2001, 129(1): 55–65
Rickaert F, Cremer M, Deviere J, Tavares L, Lambilliotte J P, Schroder S, Wurbs D, Kloppel G. Intraductal mucinhypersecreting neoplasms of the pancreas. Gastroenterology, 1991, 101(2): 512–519
Maguchi H, Osanai M, Yanagawa N, Katanuma A, Itoh H, Takahashi K. Therapeutic strategy for mucin-producing tumor of the pancreas. Geka (Surgery), 1998, 60: 1152–1157 (in Japanese)