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. Conclusion 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.
ObjectiveTo summarize clinical features, imaging findings, and pathological characteristics of pancreas intraductal papillary mucinous neoplasm (IPMN) and to improve effect of clinical diagnosis and treatment of pancreas IPMN.MethodThe clinical data of 45 patients with pancreas IPMN who underwent surgical resection from February 2014 to February 2019 in the First Affiliated Hospital of Soochow University were retrospectively analyzed.ResultsOf the 45 patients with pancreas IPMN, 28 patients were male and 17 patients were female, aged from 44 to 81 years old with (65±21) years old. There were 35 patients with age > 60 years old. The most common clinical manifestation was the upper abdominal discomfort (26 patients) and the lesions mainly occurred in the head of pancreas (20 patients). Twenty-four (58.5%, 24/41) patients and 17 (81.0%, 17/21) patients were definitely diagnosed by the CT and MRI, respectively. Twenty-five patients underwent the pancreaticoduodenectomy, 5 patients underwent the partial pancreatectomy, 2 patient underwent the pancreatic tumor resection, 12 patients underwent the pancreatic body and tail resection, 1 patient underwent the total pancreatectomy. The pathological findings showed that 15 cases were mild dysplasia, 5 cases were moderate dysplasia, 3 cases were severe dysplasia. Six cases invaded the pancreas and its surrounding adipose tissue, 5 cases invaded the tissue outside the pancreas. After the discharge, 28/32 patients were followed up for 3 to 24 months. Among all the followed-up patients, the 1-year survival rate was 100% (28/28) and the 2-year survival rate was 96.4% (27/28). The patients underwent the CT examination on the 3rd, 6th, 12th,18th, and 24th month, no lymph node metastasis was found.ConclusionsPancreas IPMN is more common in the elderly, mainly manifests as gastrointestinal symptoms, such as upper abdominal discomfort, etc. Surgery is its main treatment mean. Preoperative diagnosis mainly depends on CT examination and MRI examination, but positive rate of MRI examination is higher. Postoperative pathological section shows different degree of dysplasia.
ObjectiveTo summarize the current status of imaging in intraductal papillary mucinous neoplasms of the pancreas (IPMN).MethodThe related literatures of imaging about IPMN of the pancreas were searched in the PubMed, CNKI, VIP, and Wanfang Data databases, etc.ResultsA variety of imaging techniques could be used to diagnosis IPMN of the pancreas, including CT, MRI, EUS, and PET-CT. The CT and MRI had great performances to diagnose and differential diagnosis of benign and malignant IPMN of the pancreas. The MRI with new targeted nanoparticle contrast agents could be used to diagnosis the early IPMN of the pancreas. The EUS was very good at detecting the wall nodules in the IPMN of the pancreas. Compared with the CT and MRI, the ability of EUS to grade IPMN of the pancreas was uncertain. The PET-CT was of high performance for the differential diagnosis between the benign and malignant IPMN of the pancreas.ConclusionsVarious imaging technologies have their own advantages in diagnosing IPMN of pancreas. MRI is currently the optimal choice when condition is permit.