胰腺囊性肿瘤诊疗及进展

Progress in diagnosis and treatment of pancreatic cystic neoplasms

胰腺囊性肿瘤(PCNs)是少见肿瘤,发病原因尚不明确,不良生活习惯(吸烟、饮酒、重咖啡、高脂高蛋白饮食等)、慢性胰腺炎、环境污染因素及遗传因素等是潜在致病因素。PCNs分为浆液性囊性肿瘤(SCN)、黏液性囊性肿瘤(MCN)、胰腺导管内乳头状黏液肿瘤(IPMN)和实性假乳头状瘤(SPN)四种类型。发病症状常不典型,早期诊断难。PCNs具有典型影像特点,单个影像检查技术对PCNs的准确性和局限性不同,CT检查在胰腺病变中仍是最基本、最主要的检查方式。MRI对于小的囊性病灶比CT更有优势。超声内镜(EUS)充分结合了内镜和超声检查的优势,与CT、MRI检查相辅相成,同时还可进行细针穿刺取病理及囊液分析。尽管PCNs大部分为良性,但只要达到切除标准,均应推荐患者进行手术治疗,严格遵循PCNs诊治流程,制订个体化PCNs治疗策略,使患者利益最大化。

Pancreatic cystic neoplasms(PCNs)are rare tumors,the causes of which are not clear yet.Unhealthy lifestyle(smoking,drinking,heavy coffee,high-fat and high-protein diet,etc.),chronic pancreatitis,environmental pollution factors and genetic factors are potential pathogenic factors.There are four types of PCNs:SCN,MCN,IPMN and SPN.The symptoms are often atypical.It is difficult to diagnose early.PCNs has typical imaging characteristics.The accuracy and limitations of single image examination technology are different for PCNs.CT is still the most basic and main examination method in pancreatic lesions.MRI is more advantageous than CT in small cystic lesions.Endoscopic ultrasonography(EUS)fully combines the advantages of endoscopy and ultrasound,complements CT and MRI,and EUS can also perform fine-needle aspiration for pathology and fluid analysis.Although most PCNs are benign,they should be recommended for surgical treatment as long as they meet the resection standard to maximize the interests of patients.