导管内乳头状粘液性肿瘤（IPMN）是一种可能发生在胰管细胞内的肿瘤。 IPMN肿瘤会产生粘液，并且该粘液会形成胰腺囊肿。尽管导管内乳头状粘液性肿瘤是良性肿瘤，但它们可以发展为胰腺癌。因此，IPMN被视为癌前状态。一旦发现导管内乳头状粘液性肿瘤，管理方法包括严密监测和先发性手术。
导管内乳头状粘液性肿瘤的磁共振成像。
内容
1 诊断
2 治疗
3 历史
4 参考
诊断
通过组织病理学，IPMN在光学显微镜下的特征是粘液上皮细胞和胰管内的生长。粘蛋白5AC是有用的免疫组化标记。 !!显微镜检查结果！显微照片！免疫组化标记物特征性遗传改变是KRAS和GNAS的遗传改变。
IPMN的进一步子类型可以通过以下方式之一完成：
大体病理：主导管与分支导管的病变，决定了手术管理
通过光学显微镜和免疫组织化学：胃，肠，胰胆管和溶细胞。
60岁男性胰腺切除远端标本中IPMN类型的组织病理学（通过大体病理学（中心图），显微镜和免疫组织化学检查）：切除标本（c）显示MPD中的壁结节由PB型IPMN组成高度不典型增生（腺癌）（a），p53免疫染色（插入）和KRAS突变（G12V）弥散阳性。身体的BD-IPMN内衬着胃粘液样上皮，显示出低乳头状构型，轻度上皮分层，具有相同的KRAS突变（d），相似的胃IPMN组分的增殖依次累及壁结节的底部和壁的壁。周围膨胀的MPD（用红色箭头指示）（b）。尾巴的BD-IPMN内衬平坦的单层胃粘液上皮，缺乏细胞异型性和KRAS突变（e）。
治疗
主动脉IPMN的首选治疗方法是切除，因为其恶性几率约为50％。有时用常规的CT或MRI监测侧支IPMN，但最终将其切除，在这些切除的肿瘤中，恶性率为30％。 IPMN切除无恶性肿瘤后的5年生存率约为80％，恶性肿瘤为85％，但无淋巴结扩散，恶性肿瘤扩散为淋巴结为0％。手术可以包括切除胰头（胰十二指肠切除术），切除胰体和尾巴（远端胰切除术）或很少切除整个胰腺（全胰切除术）。在某些情况下，可以使用微创技术（例如腹腔镜或机器人手术）进行手术。一项使用监视，流行病学和最终结果登记表（SEER）数据的研究表明，在手术期间收获的淋巴结计数增加与侵袭性IPMN患者的存活率更高有关。
历史
1982年，日本癌症研究基金会的大桥和彦（Kazuhiko Ohashi）将IPMN报告为“产生粘蛋白的肿瘤”。
参考
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