Progress in pathological diagnosis of intraductal papillary mucinous neoplasm of the pancreas

doi:10.16139/j.1007-9610.2024.01.11

Abstract

Abstract:

Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is an important precancerous lesion to pancreatic ductal adenocarcinoma. Clinical decisions in the diagnosis and treatment of IPMN are foremost based on a profound understanding of the related pathology of IPMN. Systematic literature reviews were conducted around four aspects of macroscopic examination, microscopic examination, molecular detection and differential diagnosis of IPMN. This review provided updated perspectives on gross types, histological grades and differentiation subtypes, the composition pattern and histological classification of IPMN with invasive carcinoma, the molecular research of IPMN and important differential diagnosis. This analysis confirms the heterogeneity and heterochronous in IPMN, laying the foundation for finding new method to help clinicians developing appropriate diagnosis and treatment plans.

Key words: Intraductal papillary mucinous neoplasm(IPMN) of the pancreas, Precancerous lesion, Pathological diagnosis, Differential diagnosis

CLC Number:

R735.9

WANG Ting, WANG Chaofu, YUAN Fei. Progress in pathological diagnosis of intraductal papillary mucinous neoplasm of the pancreas[J]. Journal of Surgery Concepts & Practice, 2024, 29(01): 67-73.

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异型增生级别	组织形态	细胞形态	核分裂象
低	肿瘤细胞排列成单层或具有轴心的乳头状结构	细胞轻-中度异型，细胞核位于基底部或呈假复层排列	罕见或偶见
高	肿瘤细胞排列成复杂分支乳头、筛孔状、出芽	细胞高度异型，细胞核多形性，缺乏极性	多见或靠近管腔表面

	IPMN	PanIN	MCN	ITPN	IOPN
组织学特征
与胰管关系	相通	相通	不相通	相通	相通
附壁结节	有或无	无	无	有	有
上皮异型性	低级别、高级别	低级别、高级别	低级别、高级别	高级别	高级别
卵巢样间质	无	无	有	无	无
免疫组织化学特征
CK7/CK8/CK18/CK19	+	+	+	+	+
CK20/MUC2/CDX2	肠型+	-	-	-	杯状细胞+
MUC1	胰胆管型+	+	-/+^a)	+	+
MUC5AC	+	+	+	-	+
MUC6	可+，可-	低级别+	-	+	+
其他特殊标记	无	无	有^b)	无	有^c)