摘要
随着人口老龄化和影像学检查的普及，胰腺囊性肿瘤检出率逐年升高。临床上常见的是胰腺导管内乳头状黏液性肿瘤（IPMN）、黏液性囊腺瘤（MCN）、浆液性囊腺瘤（SCN）和实性假乳头状肿瘤（SPT）。鉴别诊断对决定该类肿瘤是行手术切除还是保守观察至关重要。胰腺囊性肿瘤的诊断主要依靠影像学检查。对需长期随访的患者，推荐行MRI检查。通过传统影像学、肿瘤标志物、EUS、胰管镜等各类检查手段，实现术前精确诊断，有助于制订个体化治疗方案。绝大部分SCN可予随访观察：而产黏液肿瘤（1PMN、MCN）需发现恶变相关高危因素，最后结合患者身体状况，确定行手术治疗还是随访观察。SPT已被归为恶性肿瘤，一旦影像学检查高度疑似SPT，应建议行手术切除。
With the popularization of the aging popula- tion and imaging examination, detection rate of the pancreatic cystic neoplasm are increasing in recent years, which commonly includes intraductal papillary mucinous neoplasm （IPMN）, mueinous cystic neoplasm （MCN）, serous cystic neoplasm （SCN） and solid pesudopapillary tumor （SPT）. The differential diagno- sis is essential to decide surgical resection or observation. The diagnosis of pancreatic cystic tumor relies primarily on imaging examination. For patients who need to long-term follow-up, the MRI should be recommended. The preoperative precision diagnosis that is performed by traditional imaging, tumor markers, endo- scopic ultrasonography and contribute to make the individualized therapy plan. The follow-up strategy is optimal for majority of patients with SCN. According to patients＇ condition, the surgical resection or observation will be selected for patients with IPMN or MCN after finding malignant transformation-related high risk factors. SPT has been classified as the malignant tumor, and if patients are suspected to have SPT by imaging examination, surgical resection should be recommended.
作者
楼文晖
Lou Wenhui(Department of General Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,Chin)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2018年第7期663-665,共3页
Chinese Journal of Digestive Surgery
基金
国家自然科学基金（81773068）
上海市优秀学科带头人项目（17XDl401200）
关键词
胰腺囊性肿瘤
胰腺导管内乳头状黏液性肿瘤
黏液性囊腺瘤
浆液性囊腺瘤
实性假乳头状肿瘤
手术切除
保守观察
随访
Pancreatic cystic neoplasms
Intraductalpapillary mucinous neoplasm
Mucin-ous cystic neoplasm
Serous cystic neo-plasms
Solid pesudopapillary tumor
Surgical resection
Conservative obser-vation
Follow-up
