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首页> 外文期刊>The American Journal of Surgery >Mural nodule in branch duct-type intraductal papillary mucinous neoplasms of the pancreas is a marker of malignant transformation and indication for surgery.
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Mural nodule in branch duct-type intraductal papillary mucinous neoplasms of the pancreas is a marker of malignant transformation and indication for surgery.

机译：胰腺的分支导管型导管内乳头状粘液性肿瘤中的壁瘤是恶性转化的标志和手术指示。

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摘要

BACKGROUND: The management of branch duct-type intraductal papillary mucinous neoplasms (IPMNs) remains controversial. This study aimed to elucidate the preoperative clinical factors that identify high-risk malignant transformation in branch duct-type IPMN. METHODS: We retrospectively evaluated 38 patients diagnosed with branch duct-type IPMN who underwent pancreatectomy, identifying different preoperative factors between adenoma (intraductal papillary mucinous adenoma [IPMA]) and carcinoma (intraductal papillary mucinous carcinoma [IPMC]). RESULTS: Twelve patients were diagnosed with IPMC. The mean tumor size was 31.9 +/- 11.8 mm for IPMA and 35.7 +/- 17.1 mm for IPMC (P = .467). No significant differences were found between IPMA and IPMC patients with regard to age, sex, symptoms, and tumor number. The mean diameter of the main pancreatic duct was significantly larger in IPMCs (8.3 +/- 5.9 mm) compared with IPMAs (4.7 +/- 2.3 mm; P = .011). The mural nodule was a good predictor of malignancy (P = .0002) and was identified as the only independent and significant marker of IPMC in multivariate analysis. CONCLUSIONS: The presence of mural nodules is a potentially suitable marker for differentiating IPMC from IPMA, and is important for making decisions about surgical interventions.
机译：背景：分支导管型导管内乳头状黏液性肿瘤（IPMN）的管理仍存在争议。这项研究旨在阐明确定分支导管型IPMN中高危恶性转化的术前临床因素。方法：我们回顾性评估了38例经胰管切除术诊断为分支导管型IPMN的患者，确定了腺瘤（导管内乳头状黏液性腺瘤[IPMA]）和癌（导管内乳头状黏液性癌[IPMC]）的不同术前因素。结果：12名患者被诊断出患有IPMC。 IPMA的平均肿瘤大小为31.9 +/- 11.8 mm，IPMC的平均肿瘤大小为35.7 +/- 17.1 mm（P = 0.467）。 IPMA和IPMC患者之间在年龄，性别，症状和肿瘤数量方面没有发现显着差异。与IPMAs（4.7 +/- 2.3 mm; P = 0.011）相比，IPMCs的主胰管平均直径明显更大（8.3 +/- 5.9 mm）。壁结节是恶性肿瘤的良好预测指标（P = .0002），在多变量分析中被确定为IPMC的唯一独立且重要的标志物。结论：壁膜结节的存在可能是区分IPMC和IPMA的潜在标志物，对于做出手术干预决策至关重要。

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