组织病理学分型在胰腺导管内乳头状黏液性肿瘤中的临床意义

胰腺导管内乳头状黏液性肿瘤(IPMN)是一类少见的胰腺囊性肿瘤,以胰腺导管上皮细胞乳头状异常增生合并大量黏液产生为特点。IPMN根据累及胰管不同,可以分为主胰管型、分支胰管型及混合型,病理学上表现为腺瘤至浸润癌多种类型。根据细胞形态及表达黏蛋白不同,可以分为胃型、肠型、胰胆管型及嗜酸细胞型。笔者结合既往文献及团队实践经验,分析组织病理学分型在胰腺IPMN中的临床意义,旨在提高外科医师对胰腺IPMN不同组织病理学类型的认识。

Clinical significance of pathological subtypes in the intraductal papillary mucinous neoplasm of the pancreas

The intraductal papillary mucinous neoplasm(IPMN)of the pancreas is a group of the rare pancreatic cyst neoplasms which characterized by intraductal proliferation of neoplastic mucinous cells with various degree of atypia.According to pancreatic duct invasion,the IPMN of the pancreas could be classified as main duct,branch duct and mixed duct subtypes which pathologically could be as adenoma to invasive tumors.Based on the cytomorphological features of the papillae and the immunohistochemical features of the mucin glycoproteins,the IPMN of the pancreas could be distinguished as gastric,intestinal,pancreatobiliary and oncocytic subtypes.In this article,the authors will discuss on the the clinical significance of pathological subtypes in the IPMN of the pancreas based on the review of the recent articles and their experience,in order to improve the knowledge on the different subtypes of IPMN.