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Pancreatic intraductal papillary mucinous neoplasms (IPMNs) are precancerous lesions withvariable malignant potential, highlighting the importance of accurate diagnostic and treatmentstrategies. This review summarizes recent advancements in epidemiologic understanding, molecularpathogenesis, and international/society guidelines regarding IPMN management. Therising global incidence of IPMN, driven by aging populations and increased imaging, underscoresthe growing clinical significance of these tumors. Main-duct and mixed-type subtypesexhibit much higher malignant transformation rates (approximately 59%) than branch-ductIPMN (approximately 8%). Molecular analyses identified early dual KRAS and GNAS mutationsas key drivers of IPMN, with subsequent RNF43, TP53, and SMAD4 mutations associatedwith its progression to invasive carcinoma. Diagnostic accuracy has improved with cystfluid next-generation sequencing, demonstrating high sensitivity and specificity. International/society guidelines, such as Fukuoka guidelines, American Gastroenterological Associationguidelines, European evidence-based guidelines on pancreatic cystic neoplasms, and the 2024Kyoto guidelines, differ significantly regarding surgical indications and surveillance strategies.

Notably, Kyoto guidelines incorporate molecular markers into risk assessment and suggest thediscontinuation of surveillance for small (≤ 2 cm) branch-duct IPMNs that remain stable for5 years. Innovations, such as artificial intelligence-driven radiomics, have rendered malignanttransformation more predictable. However, standardizing these technologies and addressingcost-effectiveness remain challenging. Future research directions include validating integrateddiagnostic models, refining surveillance intervals based on precise risk stratification, andexploring novel molecular and immune markers. Ultimately, adopting a comprehensive, personalizedmanagement approach for IPMN is critical to minimizing overtreatment, preventinginvasive pancreatic cancer, and optimizing patient outcomes.

Pancreatic intraductal papillary mucinous neoplasms (IPMNs) are precancerous lesions withvariable malignant potential, highlighting the importance of accurate diagnostic and treatmentstrategies. This review summarizes recent advancements in epidemiologic understanding, molecularpathogenesis, and international/society guidelines regarding IPMN management. Therising global incidence of IPMN, driven by aging populations and increased imaging, underscoresthe growing clinical significance of these tumors. Main-duct and mixed-type subtypesexhibit much higher malignant transformation rates (approximately 59%) than branch-ductIPMN (approximately 8%). Molecular analyses identified early dual KRAS and GNAS mutationsas key drivers of IPMN, with subsequent RNF43, TP53, and SMAD4 mutations associatedwith its progression to invasive carcinoma. Diagnostic accuracy has improved with cystfluid next-generation sequencing, demonstrating high sensitivity and specificity. International/society guidelines, such as Fukuoka guidelines, American Gastroenterological Associationguidelines, European evidence-based guidelines on pancreatic cystic neoplasms, and the 2024Kyoto guidelines, differ significantly regarding surgical indications and surveillance strategies.

Notably, Kyoto guidelines incorporate molecular markers into risk assessment and suggest thediscontinuation of surveillance for small (≤ 2 cm) branch-duct IPMNs that remain stable for5 years. Innovations, such as artificial intelligence-driven radiomics, have rendered malignanttransformation more predictable. However, standardizing these technologies and addressingcost-effectiveness remain challenging. Future research directions include validating integrateddiagnostic models, refining surveillance intervals based on precise risk stratification, andexploring novel molecular and immune markers. Ultimately, adopting a comprehensive, personalizedmanagement approach for IPMN is critical to minimizing overtreatment, preventinginvasive pancreatic cancer, and optimizing patient outcomes.

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기사명 저자명 페이지 원문 목차
위암 발생과 수면장애 = Sleep disorders and gastric cancer 김진옥, 김연지 p. 93-98
Glucagon-like Peptide-1 수용체작용제와 위장관 종양 = Glucagon-like peptide-1 receptor agonists and gastrointestinal neoplasms 김유진, 배재현 p. 99-106
비침습적 검사를 이용한 대장암 검진 = Recent advances in noninvasive tests for colorectal cancer screening : 최신 연구 결과 중심으로 소재승 p. 107-111
조기 발병 대장암의 역학, 위험요인 및 예후 = Early-onset colorectal cancer : epidemiology, risk factors, and prognosis 이승범 p. 112-119
Diagnosis and management of intraductal papillary mucinous neoplasms : focusing on precancerous lesions See Young Lee, Chan Min Jung, Jung Hyun Jo, Sung Ill Jang, Jae Hee Cho p. 120-130
절제불가능한 비기능성 Grade 1–2 췌장 신경내분비종양에 대한 전신 치료 = Systemic therapy of unresectable non-functioning pancreatic neuroendocrine tumor : focusing on grade 1–2 박남영, 성민제 p. 131-142
Clinical applicability of artificial intelligence-based early detection and prognosis assessment in pancreatic cancer Youngjung Kim p. 143-149
C형간염 간세포암종에서의 Direct-acting Antivirals 치료 = Direct-acting antivirals therapy for hepatocellular carcinoma in hepatitis C patients : 최근 근거 기반 고찰 한슬기, 백순구, 김문영 p. 150-156
줄기세포 오가노이드를 이용한 소화기 암 모델링 최신 연구 동향 = Recent research trends in modeling digestive cancer using stem cell organoids 김한수, 허정훈 p. 157-167
환자 유래 세포 기반 소화기암 오가노이드 제작과 맞춤형 치료 적용 = Construction and application of patient-derived organoid models for gastrointestinal cancer precision therapy 최형록, 최수민, 왕승원, 정진웅 p. 168-179
Applications of colorectal stem cell-derived organoids in drug testing and toxicity assessment Junsik Seo, Seongwoo Jeong, Yeongju Bae, Wooyoung Jeong p. 180-193
Metastatic small cell neuroendocrine carcinoma presenting with liver metastasis Hye Yeon Chon p. 194-196
췌장암에 대한 수술 전 항암화학요법으로서 FOLFIRINOX와 Gemcitabine/Nab-paclitaxel 용법에 대한 종양학적 치료결과 = Oncologic outcomes of FOLFIRINOX versus gemcitabine with nab-paclitaxel as a preoperative chemotherapy for pancreatic cancer 이윤석 p. 197-200
소화기암 환자 철결핍 빈혈(Iron Deficiency Anemia)의 관리 = Management of iron deficiency anemia in gastrointestinal cancer patient 이우주, 김은선 p. 201-202

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