胰腺导管内乳头状黏液瘤

胰腺导管内乳头状黏液瘤（IPMN）是由胰腺导管内产生黏液的上皮细胞呈乳头状增殖形成的肿瘤。与经典的胰腺癌相比，IPMN具有低度恶性、生长缓慢、少有侵犯周围组织、淋巴结转移率和再发率低的特点。IPMN根据肿瘤累及的部位可分为主胰管型、分支胰管型和混合型，病理组织特征涵盖从单纯腺瘤到浸润癌等多个亚型，临床表现多样，多种影像学检查手段可显示弥漫性或节段性扩张的主胰管和囊状扩张的分支胰管，ERCP经扩大的乳头获取黏液和胰液，取胰腺导管内皮组织和壁结节供活检均有助于诊断。IPMN确诊后应积极手术，手术切除率高，术后5年生存率高于一般的胰腺癌。本文就其临床表现、分类、病理特征、影像学诊断和治疗等方面做一综述。

Intraductal papillary mucinous neoplasm of pancreas

Intraductal papillary mucinous neoplasm （IPMN） originates from papillary proliferations of mucin-producing epithelial cells with excessive mucus production. Compared with conventional pancreatic carcinoma, IPMNs are characterized by low malignancy, slow progression, rarely invasion of surrounding structures, as well as low rate of lymph nodes metastasis as well as recurrence. Based on the site of tumor involvement, IPMNs are classified into main duct, branch duct and mixed types. Histologic type of IPMNs ranges from adenoma to invasive carcinoma. The clinic presentation of IPMNs varies and multiple radiological approaches can display diffusive or segmental dilatation of main pancreatic duct and cystic dilatation of branch ducts. Through enlarged papilla, ERCP sampling of mucin, pancreatic juice, pancreatic duct wall and mural nodules for biopsy can help diagnosis, which prompts surgery as IPMN has a high surgical resection rate and superior 5-years survival rate to conventional pancreatic carcinoma. In this article, we reviewed the clinic presentation, classification, pathological features, radiological diagnosis and treatment of IPMNs.