Pathological diagnosis and differential diagnosis of intraductal papillary tumors of the pancreas
胰腺导管内乳头状肿瘤病理诊断及鉴别诊断

摘要

目的 提高胰腺导管内乳头状肿瘤（IPMN）的病理诊断及鉴别诊断准确性。方法 选取2024年4月-2025年3月我院收治的40例胰腺导管内乳头状肿瘤病例，随机分为实验组和对照组，每组20例，对病理标本进行HE染色观察组织学形态、细胞特征，采用免疫组织化学染色检测MUC1、MUC2、MUC5AC、CDX-2等标志物表达情况，并对比胰腺导管内乳头状肿瘤与导管腺癌、黏液性囊性肿瘤、实性假乳头状瘤的特征性病理差异。结果 IPMN肿瘤细胞呈导管内乳头状生长，细胞异型性相对较小，MUC5AC高表达，MUC1多呈阴性；与胰腺导管腺癌、浆液性囊腺瘤等疾病在生长方式、细胞形态、免疫组化标志物表达等方面存在明显差异。结论 胰腺导管内乳头状肿瘤病理诊断的关键指标与鉴别要点，为临床准确诊断提供参考依据，能有效提高胰腺导管内乳头状肿瘤的诊断准确性与效率。

Abstract

Objective To improve the accuracy of pathological diagnosis and differential diagnosis of pancreatic intraductal papillary tumor (IPMN).
Methods from April 2024 to March 2025, 40 cases of intraductal papillary tumor of pancreas in our hospital were selected and randomly divided into experimental group and control group, with 20 cases in each group. The pathological specimens were stained with he to observe the histological morphology and cell characteristics. The expression of MUC1, MUC2, MUC5AC, CDX -2 and other markers were detected by immunohistochemical staining, and the characteristic pathological differences between intraductal papillary tumor of pancreas and ductal adenocarcinoma, mucinous cystic tumor, solid pseudopapillary tumor were compared.
Results IPMN tumor cells showed intraductal papillary growth with relatively small cell atypia, high expression of MUC5AC and negative expression of MUC1; It is significantly different from pancreatic ductal adenocarcinoma, serous cystadenoma and other diseases in growth mode, cell morphology, and immunohistochemical marker expression.
Conclusion   the key indicators and differential points of pathological diagnosis of pancreatic ductal papillary tumor can provide reference for clinical accurate diagnosis, and can effectively improve the diagnostic accuracy and efficiency of pancreatic ductal papillary tumor.