Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
Pancreatology. 2018 Jun;18(4):399-406. doi: 10.1016/j.pan.2018.04.005. Epub 2018 Apr 13.
The present study was conducted in order to elucidate the relationship between the number of cyst-existing regions and incidence of pancreatic ductal adenocarcinoma (PDAC) concomitant with intraductal papillary mucinous neoplasm (IPMN), which currently remains unclear.
Subjects comprised 141 patients undergoing resection for IPMN (Non-invasive IPMN (IPMN with low-to high-grade dysplasia): N = 94, invasive IPMN: N = 31, and PDAC concomitant with IPMN: N = 16) between November 2000 and February 2017. A logistic regression analysis was performed to assess the relationship between the number of cyst-existing regions (one region/two or more regions) and incidence of PDAC concomitant with IPMN, adjusted by clinical characteristics. Cyst-existing regions were defined by the number of anatomical parts of the pancreas: the head/body/tail of the pancreas.
Multiple cyst-existing regions (two or more regions) correlated with the incidence of PDAC concomitant with IPMN (PDAC concomitant with IPMN in one region vs. two or more regions: 3/66 vs. 13/75, multivariable odds ratio [OR] = 4.11, 95% confidence interval [CI] = 1.22 to 18.8, P = 0.02). In contrast, multiple cyst-existing regions did not correlate with the incidence of IPMN (invasive IPMN in one region vs. two or more regions: 13/66 vs. 18/75, OR = 1.19, 95% CI = 0.52 to 2.76, P = 0.67).
Multifocal cysts correlated with the incidence of PDAC concomitant with IPMN, and may be a high-risk factor for PDAC concomitant with IPMN.
本研究旨在阐明伴有胰管内乳头状黏液性肿瘤（IPMN）的胰腺导管腺癌（PDAC）的发生率与囊存在区域数量之间的关系，目前尚不清楚。
本研究纳入了 2000 年 11 月至 2017 年 2 月期间因 IPMN 接受手术治疗的 141 例患者（非浸润性 IPMN（低级别至高级别异型增生的 IPMN）：N=94 例，浸润性 IPMN：N=31 例，伴有 IPMN 的 PDAC：N=16 例）。采用逻辑回归分析评估囊存在区域数量（一个区域/两个或更多区域）与伴有 IPMN 的 PDAC 发生率之间的关系，并根据临床特征进行调整。囊存在区域定义为胰腺解剖部位的数量：胰头/胰体/胰尾。
多个囊存在区域（两个或更多区域）与伴有 IPMN 的 PDAC 发生率相关（一个区域存在多个囊 vs. 两个或更多区域存在多个囊：3/66 vs. 13/75，多变量比值比 [OR] = 4.11，95%置信区间 [CI] = 1.22 至 18.8，P=0.02）。相反，多个囊存在区域与 IPMN 发生率无关（一个区域存在浸润性 IPMN vs. 两个或更多区域存在浸润性 IPMN：13/66 vs. 18/75，OR=1.19，95%CI=0.52 至 2.76，P=0.67）。
多灶性囊肿与伴有 IPMN 的 PDAC 发生率相关，可能是伴有 IPMN 的 PDAC 的高危因素。
