胆管内乳头状肿瘤的临床病理分析

目的 探讨胆管内乳头状肿瘤(IPN-B)的临床病理特点及诊治方法.方法 总结1998年1月至2007年12月收治的23例IPN-B患者的临床资料,对其临床表现、病理特点、诊治及预后进行临床分析.结果 23例患者中男性13例,女性10例,年龄30～80岁,平均(61±12)岁.首发症状:无症状10例、腹痛7例、黄疸4例、表现为体质量下降和急性胆管炎者各1例;9例患者同时伴有胆管结石.肿瘤平均直径为(6±4)cm,位于肝右叶胆管4例、位于肝左叶胆管15例、位于肝外胆管4例.其中腺瘤4例、交界性肿瘤1例、原位癌6例、侵袭性癌12例.23例IPN-B患者均经手术切除病灶,平均随访时间为(33±28)个月,3年及5年生存率分别为85.3%和68.2%.结论 IPN-B是少见具有独特临床病理学特点的胆管肿瘤,手术切除是最佳治疗手段,预后较好.

A clinicopathologic study of biliary intraductal papillary neoplasm

Objective To investigate the clinicopathologic features,diagnosis and treatment of biliary intraductal papillary neoplasm(IPN-B).Methods The clinical,histopathological,treatment and prognosis data of 23 patients with IPN-B treated from January 1998 to December 2007 were retrospectively analyzed.Results There were 13 male and 10 female,aged from 30 to 80 years[mean age was(61±12)years].The clinical manifestation included 10 cases with asymptomatic,7 cages with abdominal pain,4 cases with jaundice,1 case with emaciation,and 1 case with acute cholangitis,respectively.Nine patients were also associated with hepatolithiasis.The average diameter of the tumors was(6±4)cm,4 lesions were located in the fight lobe,15 in the left lobe,and 4 in the extrahepatic bile duct.Histopathologically,there were 4 adenomas,1 borderline neoplasm,6 carcinomas in situ,and 12 carcinomas.All patients received operation;the mean duration of follow-up was(33±28)months.Overall 3-year and 5-year survival rates of IPN-B were 85.3% and 68.2% respectively.Conclusions IPN-B represents a distinct clinicopathologic entity.Favorable prognosis for IPN-B is offered by curative resection.