胰腺导管内乳头状黏液性肿瘤32例诊疗分析

Clinical analysis of 32 cases of intraductal papillary mucinous neoplasm

目的分析胰腺导管内乳头状黏液性肿瘤（IPMN）的临床表现及诊治方法。方法回顾性分析2000年1月—2015年6月于哈尔滨医科大学附属第二医院普外科就诊的32例IPMN患者的临床资料,总结其诊治方法。结果 32例患者男9例,女23例,年龄24~73岁。所有患者临床表现多无特征性。32例患者均接受手术治疗,手术效果良好。32例术后病理回报均为IPMN：非浸润性IPMN 29例,其中单纯胰腺导管内乳头状黏液性肿瘤19例,胰腺导管内乳头状黏液性肿瘤伴不典型增生9例,胰腺导管内乳头状黏液性肿瘤伴钙化1例;浸润性IPMN伴中分化腺癌3例。随访1~36个月患者预后良好,1例患者合并中分化腺癌,于术后12个月死亡。结论对于IPMN患者,MRCP有助于明确诊断。而针对不同类型IPMN的个体化治疗,可使患者获得良好的预后。

Objective To analyze the clinical manifestations and diagnosis of pancreatic intraductal papillary mucinous tumor（IPMN）.Methods Retrospective analysis of clinical data of 32 patients with IPMN who were treated in Department of General Surgery,the Second Affiliated Hospital of Harbin Medical University from January 2000 to June 2015,these cases were summarized.Results Among 32 patients,9 males and 23 females,aged from 24 to 73 years old.No characteristic of clinical manifestations were found in all patients.32 patients underwent surgical treatment,surgery showed good results.Pathological finding;32 cases were IPMN,29 cases were non-invasive IPMN,including simple pancreatic intraductal papillary mucinous tumors in 19 cases,intraductal papillary mucinous neoplasms in 9 cases with atypical hyperplasia,intraductal papillary like mucinous tumor with calcification in 1 case;within infiltrating intraductal papillary mucinous tumors of the pancreas with differentiated adenocarcinoma in 3 cases.The prognosis of patients were good after followed up of 1 to 36 months,one case with moderately differentiated adenocarcinoma,and died after 12 months.Conclusion For patients with MRCP,IPMN is helpful for the diagnosis.For individual treatment of different types of IPMN,it can get a good prognosis.