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J Gastroenterology: 保守治疗胰管内乳头状黏液性肿瘤临床结果分析

2020-11-14 MedSci原创 MedSci原创

目前临床指南均强烈建议对具有高风险的胰管内乳头状黏液性肿瘤患者进行手术切除导管内乳头状粘液性肿瘤(IPMN)。但是,由于临床结果尚不明确,本项多中心观察性研究旨在阐明了未接受手术的IPMN患者的结局。

背景及目的

目前临床指南均强烈建议对具有高风险的胰管内乳头状黏液性肿瘤患者进行手术切除导管内乳头状粘液性肿瘤(IPMN)。但是,由于临床结果尚不明确,本项多中心观察性研究旨在阐明了未接受手术的IPMN患者的临床结局。

 

 

方法

这项研究招募了101名IPMN患者,这些患者在日本的11所医院(2011-2016年)接受了随访观察。中位观察期为37个月(最长:86个月)。主要结果估计为5年总生存期(OS)和疾病特异性生存期(DSS)。生存率也根据肿瘤情况特征进行了分层。

 

 

结果

在101例患者中,有32例(31.7%)的主胰管(MPD)≥10 mm,80例(79.2%)的壁结节≥5 mm。估计的5年OS和DSS分别为74%和91%。在分层分析中,MPD≥10 mm和壁结节≥5 mm或壁结节≥10 mm并存与5年DSS恶化有关(p  = 0.003)。

 

 

结论

保守治疗的IPMN伴有结节结节和主导管扩张的患者的5年DSS估计为91%。仅具有多个大柱头样肿瘤或大结节形成的IPMN患者可能会增加死亡风险。

 

 

 

原始出处:

Arata Sakai, Atsuhiro Masuda. Et al. Clinical outcome of conservatively managed pancreatic intraductal papillary mucinous neoplasms with mural nodules and main duct dilation. Journal of Gastroenterology.2020.

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    2021-08-02 许安
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本研究旨在评价和比较表观扩散系数(ADC)与标准化ADC(病变与脾ADC比值)在鉴别胰腺神经内分泌肿瘤(NET)与胰腺内副脾(IPAS)的价值,并将结果发表在Eur Radiol上。

介入冲在前,外科灭原发,内科大巩固——基于MDT的晚期胰腺神经内分泌肿瘤综合治疗新模式

超过65%的胰腺神经内分泌肿瘤患者在首诊时已经是晚期,大部分患者已经出现较弥漫的肝转移,往往失去了外科手术根治机会。肝转移瘤病灶可以通过介入肝动脉栓塞术(TAE)联合全身治疗得到有效地缓解。目前中山大学附属第一医院神经内分泌瘤肝转移的TAE治疗客观缓解率超过80%,为晚期神经内分泌肿瘤肝转移治疗的利器。

JCEM:MEN1型中胰腺神经内分泌肿瘤自然进程如何?

大家都知道胰腺神经内分泌肿瘤(pNETs)在多发性内分泌肿瘤1型(MEN1)中非常普遍,而转移性疾病则是MEN1相关死亡发生的重要原因。尤其是小的非功能性(NF)的pNETs给主治医师提出了挑战,进而也更需要关于其自然进程的信息。近日在JCEM上发表的一篇文章则评估了在荷兰MEN1人群中小NF-pNETs的历史进程。

Oncotarget:手术切除有利于胰腺神经内分泌肿瘤患者生存!

pNENs,pancreatic neuroendocrineneoplasm,即胰腺神经内分泌肿瘤,依据激素的分泌状态和患者的临床表现可分为功能性pNENs和无功能性pNENs。多为散发,发病高峰为40-69岁,男女发病率无明显差别。

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