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十二指肠乳头扩张口对胰腺管内乳头状黏液性肿瘤的诊断意义

发布日期:2014-1-29 12:40:48 文章来源:GIE 作者次数:1523
    20111224收到,2012320批准,201264网上发布。

    背景

    总所周知,内镜筛选或内镜下逆行胰胆管造影期间发现的十二指肠乳头的扩张口是管内乳头状黏液性肿瘤(IPMN)的具体发现之一。然而,目前还不清楚其临床意义。

    目的

    评估十二指肠乳头扩张口的诊断意义以及评价这是否能成为恶性肿瘤的预测因子或者亚型IPMN

    设计

    回顾性研究。

    环境

    大学附属医院。

    患者

    本研究包括149例于19871月至20116月接受胰腺切除术治疗管内乳头状黏液性肿瘤患者。

    干预

    内镜下逆行胰胆管造影术

    主要测量指标

    恶性和肠型IPMN在患乳头扩张和未患乳头扩张的患者中的发生率。

    结果

    十二指肠乳头扩张口与肠型IPMN显著相关(P <0 .001),但是该发现结果无法预测IPMN的恶性程度(P =0 .13)。多元分析表明,扩张口是一项预测主胰管(P =0 .01)和分支胰管IPMNP <0 .001)中肠型的重要因素。

    局限性

    乳头扩张界定的有效性、选择偏倚和回顾性研究。

    结论

    十二指肠乳头扩张口可能是一项预测肠型IPMN的重要因素。这可能会使IPMN患者得到更好的临床管理。

    缩写词:IPMN,管内乳头状粘液肿瘤;MPD,主要胰腺管。

     


    Diagnostic significance of a dilated orifice of the duodenal papilla in intraductal papillary mucinous neoplasm of the pancreas

    Received 24 December 2011; accepted 20 March 2012. published online 04 June 2012.

    Background

    A dilated orifice of the duodenal papilla found during screening endoscopy or ERCP is well-known as one of the specific findings of intraductal papillary mucinous neoplasm (IPMN). However, its clinical significance is still unclear.

    Objective

    To assess the diagnostic significance of a dilated orifice of the duodenal papilla and evaluate whether this could be a factor predictive of malignancy or a subtype of IPMN.

    Design

    Retrospective study.

    Setting

    University hospital.

    Patients

    This study involved 149 patients who underwent pancreatectomy for IPMN between January 1987 and June 2011.

    Intervention

    ERCP.

    Main Outcome Measurements

    The rate of malignant and intestinal type IPMNs in patients with and without papillary dilation.

    Results

    A dilated orifice of the duodenal papilla was significantly associated with intestinal type IPMN (P < .001), but this finding could not predict the malignant grade of IPMN (P = .13). Multivariate analysis revealed that a dilated orifice was a significant factor for predicting intestinal type in both main duct (P = .01) and branch duct IPMNs (P < .001).

    Limitations

    The validity of the definition of papillary dilation, selection bias, and a retrospective study.

    Conclusion

    A dilated orifice of the duodenal papilla could be a significant factor for predicting intestinal type IPMN. This may lead to better clinical management of patients with IPMN.

    Abbreviations:  IPMN, intraductal papillary mucinous neoplasm, MPD, main pancreatic duct

     

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