背景：胰腺导管内嗜酸细胞性乳头状肿瘤(intraductal oncocytic papillary neoplasm,IOPN)是1种罕见肿瘤。最近的分子生物学数据表明，IOPN与其他导管内乳头状肿瘤明显不同；然而，它的临床病理特征,特别是浸润性癌成分发生率/重要性和生物学行为有待进一步阐明。
设计：分析24例IOPN的临床病理特征和生存率。根据定义，所有肿瘤均显示导管内生长方式和嗜酸性细胞形态。
结果：女性和男性发生比率为1.7:1；平均年龄为59岁。44%的患者是偶然发现；然而，42%的病例初步诊断为“导管腺癌”。14例IOPN发生在胰头部，中位肿瘤大小为4.5cm。肿瘤常沿邻近的良性导管生长，与浸润相似，但只有29%的病例显示明确的浸润性癌，多数是显微镜下发现局灶性病变(pTla=4、pT1b=1、 pT2=2),仅有6%的病例有淋巴结转移。浸润性癌明显由衬覆嗜酸性细胞的小管组成，或在导管周围间质中有散在的嗜酸性细胞浸润。18例患者获得随访信息(中位随访时间=6.8年)。没有患者死于该病，10年生存率为94%。浸润性IOPN患者较无浸润性IOPN患者具有更低的5年无复发生存率(66%和93%, p=0.066),但浸润性病变对总生存率没有影响(P=0.38)。
结论：IOPN是胰腺的1种独立肿瘤亚型。虽然其形态学较为复杂且常出现邻近导管的派杰样播散,仅在29%的病例中观察到普通型浸润性癌，通常于显微镜下发现局灶性病变，因此，即便有浸润性癌出现，IOPN展示出惰性的生物学行为也不足为怪。
Am J Surg Pathol 2019;43:656-661
(张帆 翻译/审校)
(张帆 翻译/审校)
The American Journal of Surgical Pathology 中文版版权说明：
©2019 Wolters Kluwer Health.
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【本文经《美国外科病理学杂志》授权发布，其他媒体转载或引用须经《美国外科病理学杂志》同意 ，否则追究法律责任；所有文章仅供公益交流，不代表本站立场。欢迎提供素材、资料等，投稿邮箱： tougao@91360.com，一经采纳将给予稿费】
©2019 Wolters Kluwer Health.
This material is from Wolters Kluwer Health, and authorize to 91360 Medical Group（Shen Zhen）Co.,Ltd. (91360 Pathologist group) and Shanghai EBM Info Tech Co., Ltd. (CME Window) freely distribute such material to medical professionals. No part of this material may be reproduced in any form, stored in a retrieval system or transmitted in any form, by any means.
Opinions expressed in this material are not necessarily those of Wolters Kluwer or associates. No responsibility is assumed by Wolters Kluwer or associates, for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made.
【本文经《美国外科病理学杂志》授权发布，其他媒体转载或引用须经《美国外科病理学杂志》同意 ，否则追究法律责任；所有文章仅供公益交流，不代表本站立场。欢迎提供素材、资料等，投稿邮箱： tougao@91360.com，一经采纳将给予稿费】
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