胰腺导管内乳头状黏液性肿瘤的研究进展

The research progress of intraductal papillary mucinous neoplasms

目的总结胰腺导管内乳头状黏液性肿瘤(IPMNs)的研究进展。方法查阅近年来国内外有关IPMNs的研究文献并做综述。结果 IPMNs根据肿瘤累及部位可分为主胰管型、分支胰管型和混合型,根据组织学特点又可分为肠型、胰胆管上皮型、胃型及嗜酸细胞型;其病理特征及临床表现多样;多种影像学检查,包括内镜逆行胆胰管造影(ERCP)、超声内镜(EUS)、CT、MRI联合磁共振胆胰管水成像(MRCP)等,可显示IPMNs的形态及功能特征,并能进行肿瘤恶性风险度的预测;在IPMNs的发生发展过程中部分基因(包括KRAS、BRAF、GNAS等基因)的功能逐渐被证实。结论 IPMNs是一种在临床病理、影像学表现及分子生物学改变方面与胰腺其他肿瘤差异较大的病变,如何将上述三者联系起来,有待进一步研究。

Objective To summarize the research progress of intraductal papillary mucinous neoplasms （IPMNs）. Method The domestic and international published literatures related to IPMNs in recent years were collected and reviewed. Results Based on the site of tumor involved, IPMNs were classified into main duct, branch duct, and mixed types. According to the histologic features, IPMNs were divided into intestinal, pancreatobiliary, gastric, and oncocytic types. The pathological and clinical presentations of IPMNs were vary, and multiple imaging approaches including endoscopic retrograde cholangiopancreatography （ERCP）, endoscopic ultrasonography （EUS）, CT, magnetic resonance cholangiopancreatography （MRCP） combined with MRI, could display morphologic and functional characteristics of IPMNs. In additon, the risk of malignancy in IPMNs could be evaluated and the functions of some genes （including KRAS, BRAF, GNAS, and so on） in the development process of IPMNs had been confirmed. Condusi^n IPMNs is a kind of disease different from other tumors of the pancreas in clinicopathologic features, imaging performance, and molecular biology changes, and how to link the above three aspects needs to be further studied.