Rivero-Moreno Yeisson, Goyal Aman, Bolívar Victor, Osagwu Nnenna, Echevarria Sophia, Gasca-Insuasti José, Pereira-Graterol Freddy, von Ahrens Dagny, Gaytán Fuentes Omar Felipe, Suárez-Carreón Luis Osvaldo, Vladimirov Miljana, Pascotto Beniamino, Azagra Juan Santiago, Calomino Natale, Abou-Mrad Adel, Marano Luigi, Oviedo Rodolfo J
Montefiore Medical Center, Department of Surgery, New York, NY 10451, USA.
Universidad de Oriente, Núcleo Anzoátegui, Anzoátegui 6001, Venezuela.
Cancers (Basel). 2025 Jan 2;17(1):122. doi: 10.3390/cancers17010122.
This systematic review and meta-analysis aimed to determine the degree to which pancreaticobiliary maljunction (PBM) increases the risk of different types of biliary cancer (BC).
A systematic review and meta-analysis were carried out using the following databases: PubMed, Embase, Cochrane Library, Scopus, Web of Science, and Science Direct. We systematically searched from inception to April 2024. The search terms included were derived from the keywords "Pancreaticobiliary Maljunction" OR "Anomalous Pancreaticobiliary Junction" AND "Cancer" OR "Malignancy". Studies that provided data comparing BC rates in relation to PBM presence or vice versa were included. The Newcastle-Ottawa Scale (NOS) was used for quality assessment. The random-effects model was used.
Fifteen studies were included with a total sample of 8604 patients, of whom 5015 (58.29%) were female with a mean age of 54.58 years. Patients with PBM had 8.42 (95% CI = 3.57-19.87) more risk of developing any type of BC, with a higher risk of GBC than BDC (OR = 16.91 vs. OR = 3.36, -value = 0.003). There was a higher risk of having PBM in patients with GBC than BDC only when considering the Asian population (OR = 3.12, 95% CI = 1.09-8.94). Meta-regression analysis revealed that neither mean age ( = 0.087) nor percentage of female patients in the study population ( = 0.197) were statistically associated with the variations in OR for the risk of BC based on the presence of PBM.
There is a significant association between PBM and the risk of having BC, mainly GBC when compared to BDC. Most of the studies published reported data from Japanese patients, which limits the generalization of the results. The age of patients and sex were not significantly associated with the relation between PBM and BC. Further prospective studies in broader populations will provide additional details to take measures for screening and early management of PBM and BC.
本系统评价和荟萃分析旨在确定胰胆管合流异常（PBM）增加不同类型胆管癌（BC）风险的程度。
使用以下数据库进行系统评价和荟萃分析：PubMed、Embase、Cochrane图书馆、Scopus、科学网和科学Direct。我们从数据库创建到2024年4月进行了系统检索。纳入的检索词源自关键词“胰胆管合流异常”或“异常胰胆管连接”以及“癌症”或“恶性肿瘤”。纳入提供了比较有或无PBM情况下BC发生率数据的研究。采用纽卡斯尔-渥太华量表（NOS）进行质量评估。使用随机效应模型。
纳入15项研究，总样本量为8604例患者，其中5015例（58.29%）为女性，平均年龄54.58岁。有PBM的患者发生任何类型BC的风险高8.42倍（95%置信区间=3.57-19.87），发生胆囊癌（GBC）的风险高于胆管癌（BDC）（比值比=16.91对比值比=3.36，P值=0.003）。仅考虑亚洲人群时，GBC患者有PBM的风险高于BDC患者（比值比=3.12，95%置信区间=1.09-8.94）。荟萃回归分析显示研究人群的平均年龄（P=0.087）和女性患者百分比（P=0.197）与基于PBM存在情况的BC风险比值比变化均无统计学关联。
PBM与BC风险之间存在显著关联，与BDC相比主要是GBC。大多数已发表的研究报告的是日本患者的数据，这限制了结果的推广。患者年龄和性别与PBM和BC之间的关系无显著关联。在更广泛人群中进行进一步的前瞻性研究将为采取PBM和BC的筛查及早期管理措施提供更多细节。
