Nakagawa Takashi, Masuda Atsuhiro, Toyama Hirochika, Shiomi Hideyuki, Zen Yoh, Sofue Keitaro, Takenaka Mamoru, Kobayashi Takashi, Yagi Yosuke, Yamanaka Kodai, Yoshida Masaru, Arisaka Yoshifumi, Okabe Yoshihiro, Kutsumi Hiromu, Fukumoto Takumi, Ku Yonson, Azuma Takeshi
From the *Division of Gastroenterology, Department of Internal Medicine, †Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, ‡Division of Diagnostic Pathology, §Department of Radiology, Kobe University Graduate School of Medicine, Hyogo; and ∥Center for Clinical Research and Advanced Medicine Establishment, Shiga University of Medical Science, Otsu, Japan.
Pancreas. 2017 Apr;46(4):582-588. doi: 10.1097/MPA.0000000000000761.
The effect of smoking status on the incidence of pancreatic ductal adenocarcinoma (PDAC) concomitant with intraductal papillary mucinous neoplasm (IPMN) has not been clarified. This study investigated the association of smoking status with PDAC concomitant with IPMN.
The subjects were 124 consecutive patients undergoing resection of IPMNs (intraductal papillary mucinous adenoma (IPMA): N = 77, invasive IPMN: N = 31, and PDAC with IPMN: N = 16) between April 2008 and October 2015. The associations between smoking status (never/former/current smoker) or cumulative pack-years (0-19/20-39/≥40) and the incidence of PDAC concomitant with IPMN or invasive IPMN were evaluated.
Current smoking, not former smoking, was associated with the incidence of PDAC concomitant with IPMN (PDAC with IPMN vs IPMN alone; P = 0.004, PDAC with IPMN vs IPMA; P = 0.004, PDAC with IPMN vs invasive IPMN; P = 0.04, respectively), but not that of invasive IPMN (invasive IPMN vs IPMA; P = 0.85). Cumulative pack-years were higher in patients who had PDAC concomitant with IPMN than in patients with invasive IPMN (P = 0.04). Cumulative pack-years were not associated with smoking status (current vs former).
Current smoking, not former smoking, was associated with the incidence of PDAC concomitant with IPMN. Cessation of smoking may be recommended for patients with IPMN.
吸烟状态对伴发导管内乳头状黏液性肿瘤（IPMN）的胰腺导管腺癌（PDAC）发病率的影响尚未明确。本研究调查了吸烟状态与伴发IPMN的PDAC之间的关联。
研究对象为2008年4月至2015年10月期间连续124例行IPMN切除术的患者（导管内乳头状黏液性腺瘤（IPMA）：77例，浸润性IPMN：31例，伴IPMN的PDAC：16例）。评估吸烟状态（从不吸烟/曾经吸烟/当前吸烟）或累积吸烟包年数（0 - 19/20 - 39/≥40）与伴IPMN的PDAC或浸润性IPMN发病率之间的关联。
当前吸烟而非曾经吸烟与伴IPMN的PDAC发病率相关（伴IPMN的PDAC与单独IPMN相比；P = 0.004，伴IPMN的PDAC与IPMA相比；P = 0.004，伴IPMN的PDAC与浸润性IPMN相比；P分别为0.04），但与浸润性IPMN的发病率无关（浸润性IPMN与IPMA相比；P = 0.85）。伴IPMN的PDAC患者的累积吸烟包年数高于浸润性IPMN患者（P = 0.04）。累积吸烟包年数与吸烟状态（当前吸烟与曾经吸烟）无关。
当前吸烟而非曾经吸烟与伴IPMN的PDAC发病率相关。对于IPMN患者，建议戒烟。
