Hassan Aziz, Peyton Seda, Matthew Gosse, Yashant Aswani, Timothy M Pawlik
{"title":"胆管内乳头状肿瘤。","authors":"Hassan Aziz, Peyton Seda, Matthew Gosse, Yashant Aswani, Timothy M Pawlik","doi":"10.1016/j.hpb.2025.08.017","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Intraductal papillary neoplasm of the bile duct (IPNB) was formally adopted in the 2010 WHO classification as a distinct clinical and pathological entity. We herein review the concept, clinical and pathologic features, as well as the prognosis of IPNB.</p><p><strong>Methods: </strong>A comprehensive review was conducted using MEDLINE/PubMed, Google Scholar, Cochrane Library, and the Web of Science, which were accessed between 2004 and 2025. The main search focused on \"Intraductal papillary neoplasm of the bile duct.\"</p><p><strong>Results: </strong>IPNB often present with intermittent right upper quadrant abdominal pain, recurrent episodes of acute cholangitis, obstructive jaundice with macroscopic or microscopic mucin, and dilation of the proximal bile duct. On histology, IPNB is characterized by papillary proliferation of neoplastic biliary epithelial cells with delicate fibrovascular stalks within the bile duct. MRI, including MRCP, has the highest diagnostic sensitivity (65.5 %) followed by CT (50 %). Surgical resection with a negative margin is the treatment of choice. In contrast to flat intraductal neoplasia-associated cholangiocarcinoma, IPNB has a better prognosis and postoperative outcome with a 5-year survival of 70-81 % although risk of recurrence can be high.</p><p><strong>Conclusion: </strong>Clinicians need to be familiar with the presentation, diagnosis, and treatment of IPNB lesions.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intraductal papillary neoplasm of the bile duct.\",\"authors\":\"Hassan Aziz, Peyton Seda, Matthew Gosse, Yashant Aswani, Timothy M Pawlik\",\"doi\":\"10.1016/j.hpb.2025.08.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Intraductal papillary neoplasm of the bile duct (IPNB) was formally adopted in the 2010 WHO classification as a distinct clinical and pathological entity. We herein review the concept, clinical and pathologic features, as well as the prognosis of IPNB.</p><p><strong>Methods: </strong>A comprehensive review was conducted using MEDLINE/PubMed, Google Scholar, Cochrane Library, and the Web of Science, which were accessed between 2004 and 2025. The main search focused on \\\"Intraductal papillary neoplasm of the bile duct.\\\"</p><p><strong>Results: </strong>IPNB often present with intermittent right upper quadrant abdominal pain, recurrent episodes of acute cholangitis, obstructive jaundice with macroscopic or microscopic mucin, and dilation of the proximal bile duct. On histology, IPNB is characterized by papillary proliferation of neoplastic biliary epithelial cells with delicate fibrovascular stalks within the bile duct. MRI, including MRCP, has the highest diagnostic sensitivity (65.5 %) followed by CT (50 %). Surgical resection with a negative margin is the treatment of choice. In contrast to flat intraductal neoplasia-associated cholangiocarcinoma, IPNB has a better prognosis and postoperative outcome with a 5-year survival of 70-81 % although risk of recurrence can be high.</p><p><strong>Conclusion: </strong>Clinicians need to be familiar with the presentation, diagnosis, and treatment of IPNB lesions.</p>\",\"PeriodicalId\":13229,\"journal\":{\"name\":\"Hpb\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hpb\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.hpb.2025.08.017\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hpb","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hpb.2025.08.017","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：胆管导管内乳头状肿瘤（IPNB）在2010年WHO分类中被正式采纳为一个独特的临床和病理实体。本文就IPNB的概念、临床和病理特征以及预后进行综述。方法：对2004 - 2025年的MEDLINE/PubMed、谷歌Scholar、Cochrane Library和Web of Science数据库进行综合分析。主要搜索集中在“胆管内乳头状肿瘤”。结果：IPNB常表现为间歇性右上腹部疼痛，急性胆管炎反复发作，梗阻性黄疸伴肉眼或镜下粘液，近端胆管扩张。在组织学上，IPNB的特征是胆管内肿瘤性胆管上皮细胞乳头状增生，伴有纤细的纤维血管梗。MRI（包括MRCP）的诊断敏感性最高（65.5%），其次是CT（50%）。手术切除阴性切缘是治疗的选择。与平坦导管内肿瘤相关的胆管癌相比，IPNB具有更好的预后和术后结果，5年生存率为70- 81%，尽管复发风险可能很高。结论：临床医生需要熟悉IPNB病变的表现、诊断和治疗。
Background: Intraductal papillary neoplasm of the bile duct (IPNB) was formally adopted in the 2010 WHO classification as a distinct clinical and pathological entity. We herein review the concept, clinical and pathologic features, as well as the prognosis of IPNB.
Methods: A comprehensive review was conducted using MEDLINE/PubMed, Google Scholar, Cochrane Library, and the Web of Science, which were accessed between 2004 and 2025. The main search focused on "Intraductal papillary neoplasm of the bile duct."
Results: IPNB often present with intermittent right upper quadrant abdominal pain, recurrent episodes of acute cholangitis, obstructive jaundice with macroscopic or microscopic mucin, and dilation of the proximal bile duct. On histology, IPNB is characterized by papillary proliferation of neoplastic biliary epithelial cells with delicate fibrovascular stalks within the bile duct. MRI, including MRCP, has the highest diagnostic sensitivity (65.5 %) followed by CT (50 %). Surgical resection with a negative margin is the treatment of choice. In contrast to flat intraductal neoplasia-associated cholangiocarcinoma, IPNB has a better prognosis and postoperative outcome with a 5-year survival of 70-81 % although risk of recurrence can be high.
Conclusion: Clinicians need to be familiar with the presentation, diagnosis, and treatment of IPNB lesions.
期刊介绍：
HPB is an international forum for clinical, scientific and educational communication.
Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice.
Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice.
HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields.
Abstracted and Indexed in:
MEDLINE®
EMBASE
PubMed
Science Citation Index Expanded
Academic Search (EBSCO)
HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
