한국에서의 췌장 점액낭종양과 관내유두점액종양의 유병률과 임상병리학적 소견에 대한 연구

Abstract

Background : Mucin producing cystic neoplasms, such as mucinous cystic tumor (MCT) and intraductal papillary mucinous tumor (IPMT) of the pancreas, are uncommon but become increasing in their incidences. The pathologic classification and biologic potential of these neoplasms remain the subject of controversy. Methods : The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists analyzed the clinicopathologic characteristics of 85 cases of MCT and 72 cases of IPMT and examined the expression patterns of p53, CEA and MUC1. Results : IPMT was located largely in the head, and showed connection with the main pancreatic duct (MPD, 68.1%), no ovarian-like stroma (0/72), and presence of intervening intratumoral normal or atrophic parenchyma. On the other hand, MCT was located largely in the tail (73%), and showed common ovarian-like stroma (66/80), rare connection with the MPD (7/85) and no intervening pancreatic parenchyma. CEA and p53 immunoexpressions were significantly increased from adenoma through borderline to carcinoma, but MUC 1 was expressed only in the invasive carcinoma among cases of MCT and IPMT. Conclusions : The tumor location, ovarian-like stroma, connection with the MPD and intratumoral intervening nonneoplastic tissue were helpful in the differential diagnosis between IPMT and MCT. CEA and p53 expressions can be indicators of malignancy, while MUC 1 expression can indicate invasion.