美国胃肠病学会官方杂志Clin Gastroenterol Hepatol发表了山东大学齐鲁医院普外科李涛副主任医师关于肝脏黏液性囊性肿瘤和胆管内乳头状肿瘤的文章。长期以来，肝脏的囊性肿瘤多被误诊为肝脏囊腺瘤或囊腺癌，而影响临床医生采取正确的治疗及预防措施。 本文在国际上第一次比较系统地的阐述了肝脏及胆管囊性肿瘤的分类，诊断，病理分型，临床表现，影像学表现，手术治疗及预后，提出了胆管内乳头状肿瘤（B-IPN）的概念并与肝脏黏液性囊性肿瘤（MCN）进行鉴别诊断，对于提高临床对肝脏及胆管的囊性肿瘤的认识具有重要意义。该文章被Elsevier医学网站评为2009年度中国作者重要发表文章。
A comparison of hepatic mucinous cystic neoplasms with biliary intraductal papillary neoplasms
Source
Department of General Surgery, Qilu Hospital, Shandong University, Jinan, China.
Abstract
BACKGROUND & AIMS:
There is controversy regarding the term biliary intraductal papillary neoplasms (IPN-B) and their pathology, which frequently are confused with hepatic mucinous cystic neoplasms (MCN). We aimed to summarize the clinicopathologic features of IPN-B and differentiate them from MCN.
METHODS:
From January 1998 to December 2007, there were 19 patients with intrahepatic IPN-B and 13 patients with MCN who underwent surgical treatment at Zhongshan Hospital. Multiple demographic and clinicopathologic parameters were reviewed retrospectively and compared between the groups.
RESULTS:
The mean ages of patients with IPN-B and MCN were 59.5 +/- 11.1 and 44.4 +/- 9.7 years, respectively (P = .0004); the male:female ratios also differed (11:8 vs 2:11; P = .028). Tumors were significantly smaller (6.0 vs 11.2 cm; P = .006) in patients with IPN-B than in those with MCN. More patients with IPN-B also had hepatolithiasis (47.4% vs 0%, P = .004); cholangiectasis and communication between the cyst and main bile duct were more frequent in patients with IPN-B than in those with MCN (P < .001). The IPN-B consisted of 4 subtypes--the gastric subtype was the least invasive. Malignant lesions were more common in patients with IPN-B than in those with MCN (78.9% vs 38.5%; P = .03). The overall 5-year survival rates of patients with IPN-B and MCN were 82% and 100%, respectively.
CONCLUSIONS:
Intrahepatic IPN-B represents a distinct clinicopathologic entity that differs clinically, histologically, and radiologically from MCN. Curative resection has a favorable prognosis for patients with IPN-B, but further studies of its subtype are required.
