胰腺导管内乳头状黏液性肿瘤患者的胰腺外恶性肿瘤：患病率、相关因素及与其他胰腺囊性肿瘤患者的比较。

Extrapancreatic malignancies in patients with intraductal papillary mucinous neoplasm of the pancreas: prevalence, associated factors, and comparison with patients with other pancreatic cystic neoplasms.

作者信息

Yoon Won Jae, Ryu Ji Kon, Lee Jun Kyu, Woo Sang Myung, Lee Sang Hyub, Park Joo Kyung, Kim Yong-Tae, Yoon Yong Bum

机构信息

Division of Gastroenterology, Department of Internal Medicine, Seoul National University College of Medicine, 28 Yeongon-dong, Jongno-gu, Seoul 110-744, Korea.

出版信息

Ann Surg Oncol. 2008 Nov;15(11):3193-8. doi: 10.1245/s10434-008-0143-4. Epub 2008 Sep 11.

DOI:10.1245/s10434-008-0143-4

PMID:18784959

Abstract

BACKGROUND

Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is reported to have a high prevalence of extrapancreatic malignancy (EPM). The aims of this study were to evaluate the prevalence and associated factors of EPMs in IPMN patients and to compare these data with those of non-IPMN pancreatic cystic neoplasm (PCN) patients.

METHODS

The study included 385 PCN patients (210 IPMNs and 175 non-IPMNs) diagnosed from 1993 to 2007. PCN types, presence of EPMs, chronological relation of EPMs to PCN diagnosis, and their clinicopathological parameters were analyzed.

RESULTS

The prevalence of EPM was 33.8% for IPMNs and 12.0% for non-IPMN PCNs (P < 0.001). In the majority of patients with EPMs, PCNs were detected while undergoing workup for the EPMs. For IPMNs, age was associated with EPMs [odds ratio (OR) 1.05, P = 0.013]; malignant IPMN showed a borderline inverse association with EPMs (OR 0.50, P = 0.071). Multivariate analysis of entire PCN cohort demonstrated that age at PCN diagnosis (OR 1.05, P < 0.001) was positively associated with EPM; IPMN showed a borderline positive association with EPM (OR 1.88, P = 0.052). Malignant PCN (OR 0.40, P = 0.009) was inversely associated with EPM.

CONCLUSION

The EPM prevalence of IPMN patients was 33.8%. Advanced age at IPMN diagnosis was the only factor significantly associated with EPMs in our IPMN cohort. In our PCN cohort, advanced age at PCN diagnosis was associated with malignant PCN and IPMN showed a borderline positive association with EPM.

摘要

背景

据报道，胰腺导管内乳头状黏液性肿瘤（IPMN）患者发生胰腺外恶性肿瘤（EPM）的比例较高。本研究旨在评估IPMN患者中EPM的发生率及相关因素，并将这些数据与非IPMN胰腺囊性肿瘤（PCN）患者的数据进行比较。

方法

本研究纳入了1993年至2007年期间诊断的385例PCN患者（210例IPMN和175例非IPMN）。分析了PCN类型、EPM的存在情况、EPM与PCN诊断的时间关系及其临床病理参数。

结果

IPMN患者中EPM的发生率为33.8%，非IPMN PCN患者中为12.0%（P<0.001）。在大多数EPM患者中，PCN是在对EPM进行检查时发现的。对于IPMN患者，年龄与EPM相关[比值比（OR）1.05，P=0.013]；恶性IPMN与EPM呈临界负相关（OR 0.50，P=0.071）。对整个PCN队列进行多变量分析表明，PCN诊断时的年龄（OR 1.05，P<0.001）与EPM呈正相关；IPMN与EPM呈临界正相关（OR 1.88，P=0.052）。恶性PCN（OR 0.40，P=0.009）与EPM呈负相关。