Department of Surgery, Johns Hopkins Hospital, 600 N. Wolfe Street Osler 624, Baltimore, MD, 21287, USA.
Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, 21287, USA.
J Gastrointest Surg. 2019 Mar;23(3):477-483. doi: 10.1007/s11605-018-3795-9. Epub 2018 Sep 4.
Intraductal papillary mucinous neoplasms (IPMNs) are precursor lesions to the development of pancreatic adenocarcinoma. We determined if non-O blood groups are more common in patients with IPMN and if blood group is a risk factor for progression to invasive pancreatic cancer among patients with IPMN.
The medical records were reviewed of all patients undergoing resection of an IPMN at Johns Hopkins Hospital from June 1997 to August 2016. Potential risk factors of high-grade dysplasia and associated adenocarcinoma were identified through a multivariate logistic regression model.
Seven hundred and seventy-seven patients underwent surgical resection of an IPMN in which preoperative blood type was known. Sixty-two percent of IPMN patients had non-O blood groups (vs. 57% in two large US reference cohorts, P = 0.002). The association between non-O blood group was significant for patients with IPMN with low- or intermediate-grade dysplasia (P < 0.001), not for those with high-grade dysplasia (P = 0.68). Low- and intermediate-grade IPMNs were more likely to have non-type O blood compared to those with high-grade IPMN and/or associated invasive adenocarcinoma (P = 0.045). Blood type O was an independent predictor of having high-grade dysplasia without associated adenocarcinoma (P = 0.02), but not having associated invasive cancer (P = 0.72). The main risk factor for progression to invasive cancer after surgical resection was IPMN with high-grade dysplasia (P = 0.002).
IPMN patients are more likely to have non-O blood groups than controls, but type O blood group carriers had higher odds of having high-grade dysplasia in their IPMN. These results indicate blood group status may have different effects on the risk and progression of IPMNs.
导管内乳头状黏液性肿瘤（IPMN）是胰腺癌发展的前体病变。我们确定非 O 血型是否在 IPMN 患者中更为常见，以及血型是否是 IPMN 患者发展为浸润性胰腺癌的危险因素。
回顾了 1997 年 6 月至 2016 年 8 月期间在约翰霍普金斯医院接受 IPMN 切除术的所有患者的病历。通过多变量逻辑回归模型确定高级别发育不良和相关腺癌的潜在危险因素。
777 例患者接受了 IPMN 的手术切除，其中术前血型已知。62%的 IPMN 患者为非 O 血型（与两个美国大型参考队列的 57%相比，P=0.002）。非 O 血型与低级别或中级别发育不良的 IPMN 患者显著相关（P<0.001），但与高级别发育不良的 IPMN 患者不相关（P=0.68）。与高级别 IPMN 和/或相关浸润性腺癌相比，低级别和中级别 IPMN 更可能是非 O 型血（P=0.045）。血型 O 是无相关腺癌的高级别发育不良的独立预测因子（P=0.02），但不是相关浸润性癌的独立预测因子（P=0.72）。手术切除后进展为浸润性癌的主要危险因素是高级别发育不良的 IPMN（P=0.002）。
与对照组相比，IPMN 患者更有可能具有非 O 血型，但 O 型血型携带者的 IPMN 中高级别发育不良的可能性更高。这些结果表明，血型状态可能对 IPMN 的风险和进展有不同的影响。
