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Simple Mucinous Cyst of the Pancreas: Review and Update.

胰腺单纯粘液性囊肿:综述及进展

Abstract

- According to the 2014 Baltimore Consensus Meeting, simple mucinous cysts are defined as macroscopic cysts that are greater than 1 cm in size with gastric-type flat mucinous lining and minimal cytologic atypia without ovarian-type stroma. This lesion has not been widely recognized and has undergone a recent nomenclature change owing to unclear pathogenesis and biologic behavior. Mucinous pancreatic cystic lesions are generally considered precursor lesions of pancreatic adenocarcinoma. However, simple mucinous cysts generally have benign behavior with no recurrence or malignant transformation during short follow-up periods.
- To provide a brief update and summary of the evolving nomenclature and current knowledge of simple mucinous cysts with an overview of their clinical, histopathologic, immunohistochemical, and molecular characteristics, as well as discussion of their differential diagnoses and biological behavior.
- Analysis of the pertinent literature (PubMed) and authors' clinical practice experience based on institutional and consultation materials.
- Simple mucinous cyst has undergone a nomenclature evolution from mucinous nonneoplastic cyst to the current recommended name of simple mucinous cyst to reflect its unclear pathogenesis and progression. The malignant potential of simple mucinous cyst is still debatable. Recent molecular studies support a neoplastic process, but these cysts generally exhibit benign behavior without recurrence or malignant transformation. Therefore, accurate diagnosis of simple mucinous cysts is critical to distinguish them from other more common and aggressive mucinous pancreatic cysts. Studies with larger cohorts and longer clinical follow-up data are needed to further determine the biologic behavior of this cyst and implications for prognosis.

摘要

根据2014年巴尔的摩共识会议达成的标准,单纯粘液性囊肿被定义为大的囊肿,其直径超过1厘米,囊壁衬覆有胃型扁平粘液上皮,上皮仅有轻度异型性且没有卵巢型间质。由于不清楚其发病机制和生物行为,这一病变一直没有得到广泛的认知,其命名也经过了更改。通常,胰腺粘液性囊性病变被认为是胰腺腺癌的癌前病变。然而短期的随访数据表明,单纯粘液囊肿有良好的生物学行为,一般没有复发或恶性转化可能。

-本文对单纯粘液性囊肿的命名进展及最新认识进行简单的综述和总结,并概述其临床、组织病理学、免疫组织化学和分子特性,以及对其鉴别诊断和生物学行为进行了讨论。

-对相关文献(PubMed)和作者基于本医疗机构临床及会诊资料而来的临床实践经验进行分析。

-单纯粘液囊肿的命名经历了从粘液性非肿瘤性囊肿到目前推荐的命名,这反映了对其发病机理和进展并不明确。对单纯粘液囊肿恶性潜能的认识仍有争议。最近的分子学研究支持其是肿瘤的过程,但是这些囊肿通常表现出良性的生物学行为,没有复发或恶性转化。因此,对单纯粘液囊肿进行准确诊断是与其他常见和侵袭性胰腺粘液性囊肿鉴别诊断的关键。需要更大队列及更长随访时间的临床研究来进一步确定这个囊肿的生物学行为,及其对预后的影响。


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