Wagner Anja, Aretz Stefan, Auranen Annika, Bruno Marco J, Cavestro Giulia M, Crosbie Emma J, Goverde Anne, Jelsig Anne Marie, Latchford Andrew, Leerdam Monique E van, Lepisto Anna, Puzzono Marta, Winship Ingrid, Zuber Veronica, Möslein Gabriela
Department of Clinical Genetics, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3000CA Rotterdam, The Netherlands.
Institute of Human Genetics, Medical Faculty, University of Bonn, 53127 Bonn, Germany.
J Clin Med. 2021 Jan 27;10(3):473. doi: 10.3390/jcm10030473.
The scientific data to guide the management of Peutz-Jeghers syndrome (PJS) are sparse. The available evidence has been reviewed and discussed by diverse medical specialists in the field of PJS to update the previous guideline from 2010 and formulate a revised practical guideline for colleagues managing PJS patients. Methods: Literature searches were performed using MEDLINE, Embase, and Cochrane. Evidence levels and recommendation strengths were assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). A Delphi process was followed, with consensus being reached when ≥80% of the voting guideline committee members agreed. Recommendations and statements: The only recent guidelines available were for gastrointestinal and pancreatic management. These were reviewed and endorsed after confirming that no more recent relevant papers had been published. Literature searches were performed for additional questions and yielded a variable number of relevant papers depending on the subject addressed. Additional recommendations and statements were formulated. Conclusions: A decade on, the evidence base for recommendations remains poor, and collaborative studies are required to provide better data about this rare condition. Within these restrictions, multisystem, clinical management recommendations for PJS have been formulated.
指导黑斑息肉综合征(PJS)管理的科学数据匮乏。该领域的不同医学专家对现有证据进行了回顾和讨论,以更新2010年的先前指南,并为管理PJS患者的同行制定修订后的实用指南。方法:使用MEDLINE、Embase和Cochrane进行文献检索。使用推荐分级评估、制定和评价(GRADE)对证据水平和推荐强度进行评估。采用德尔菲法,当≥80%的投票指南委员会成员达成一致时达成共识。推荐意见和声明:最近可用的指南仅针对胃肠道和胰腺管理。在确认没有发表更新的相关论文后,对这些指南进行了审查和认可。针对其他问题进行了文献检索,根据所涉及的主题产生了数量不等的相关论文。制定了额外的推荐意见和声明。结论:十年过去了,推荐意见的证据基础仍然薄弱,需要开展合作研究以提供关于这种罕见疾病的更好数据。在这些限制条件下,已制定了针对PJS的多系统临床管理建议。