外科理论与实践

外科理论与实践 >

2025 , Vol. 30 >Issue 06: 509 - 516

DOI: https://doi.org/10.16139/j.1007-9610.2025.06.09

论著

囊液性状可预测胰腺导管内乳头状黏液性肿瘤的良、恶性

  • 王敬源 ,
  • 范嘉裕 ,
  • 张平平 ,
  • 马洪运 ,
  • 陈颖 ,
  • 李刚 ,
  • 金震东 ,
  • 金钢 ,
  • 王凯旋
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  • 海军军医大学长海医院 a.消化内科，b.肝胆胰脾外科，c.病理科， 上海 200433
第一联系人：*: 共同第一作者
金钢，E-mail：Jingang@smmu.edu.cn；
王凯旋，E-mail：wangkaixuan224007@163.com

收稿日期: 2025-06-30

  网络出版日期: 2026-01-26

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Characteristics of cyst fluid can predict the benign or malignant nature of intraductal papillary mucinous neoplasms

  • WANG Jingyuan ,
  • FAN Jiayu ,
  • ZHANG Pingping ,
  • MA Hongyun ,
  • CHEN Ying ,
  • LI Gang ,
  • JIN Zhendong ,
  • JIN Gang ,
  • WANG Kaixuan
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  • a. Department of Gastroenterology; b. Department of Hepatobiliary Pancreatic Spleen Surgery; c. Department of Pathology, Changhai Hospital, Naval Medical University, Shanghai 200433, China

Received date: 2025-06-30

  Online published: 2026-01-26

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摘要

目的：探究囊液性状对导管内乳头状黏液性肿瘤（IPMN）良、恶性的预测能力。方法：前瞻性地收集从2023年9月至2024年12月在上海长海医院肝胆胰脾外科接受胰腺切除术且最终病理检查确认为IPMN病人的新鲜囊液。对囊液进行性状特征评估，包括黏稠度、清澈度、颜色，并探讨其对良、恶性的预测性能。结果：本研究共纳入40例IPMN病人。拉丝实验（+）对高级别异型增生/侵袭性癌（HGD/IC）的诊断灵敏度90.9%，特异度92.9%，准确率76.0%。肠型IPMN囊液常表现为胶冻样，胶冻样在HGD/IC组与LGD低级别异型增生（LGD）组分布差异无统计学意义。囊液CEA、葡萄糖、淀粉酶在HGD/IC组与LGD组差异无统计学意义。结论：胰腺囊液的性状，尤其是黏稠度，可有效预测IPMN良、恶性。

关键词： 胰腺导管内乳头状黏液性肿瘤; 囊液性状; 拉丝实验; 形态学亚型; 异型增生等级

本文引用格式

王敬源 , 范嘉裕 , 张平平 , 马洪运 , 陈颖 , 李刚 , 金震东 , 金钢 , 王凯旋 . 囊液性状可预测胰腺导管内乳头状黏液性肿瘤的良、恶性[J]. 外科理论与实践, 2025 , 30(06) : 509 -516 . DOI: 10.16139/j.1007-9610.2025.06.09

Abstract

Objective To investigate the predictive ability of cyst fluid characteristics for malignant intraductal papillary mucinous neoplasms (IPMNs). Methods We prospectively collected fresh cyst fluid from patients undergoing pancreatic resection at the Department of Hepatobiliary Pancreatic Spleen Surgery, Changhai Hospital, Shanghai, from September 2023 to December 2024, who were ultimately pathologically confirmed with IPMN. We assessed the characteristics of cyst fluid, including viscosity, clarity, and color, and explored its predictive performance for benign or malignant. Results A total of 40 patients with IPMN were included. The sensitivity of the string sign （+） for diagnosing high-grade dysplasia/ invasive carcinoma （HGD/IC） was 90.9%, specificity was 92.9%, and accuracy was 76.0%. The cyst fluid of intestinal-type IPMN often exhibited a gelatinous consistency, and there was no significant difference in the distribution of gelatinous consistency between the HGD/IC group and the low-grade dysplasia （LGD） group. There were no significant differences in CEA, glucose, and amylase levels in the cyst fluid between the HGD/IC group and the LGD group. Conclusions The characteristics of pancreatic cyst fluid, especially viscosity, can effectively predict the benign or malignant nature of IPMN.

Key words： Intraductal papillary mucinous neoplasm （IPMN）; Characteristics of cyst fluid; String sign; Morphological subtype; Grade of dysplasia

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