胰腺导管内乳头状黏液性肿瘤合并胰腺外恶性肿瘤特征荟萃分析

Pancreatic intraductal papillary mucinous neoplasm coexisting with extrapancreaUc malignancy： an anal- ysis of pooled published data

目的探讨胰腺导管内乳头状黏液性肿瘤（IPMN）合并胰腺外恶性肿瘤（EPM）的部分临床特点，为临床诊治胰腺IPMN提供帮助。方法以PubMed为检索数据库，对已发表的关于胰腺IPMN文献中经病理学证实的临床病例进行荟萃分析，尝试阐明胰腺IPMN病例并存EPM的发生率和EPM的发生部位（类型）及其比例。结果共筛选出符合纳入排除标准的文献18篇，共汇集病例1327例，其中并存EPM病例363例，占27．35％。该363例病例中，共统计到392处EPM。EPM几乎可发生于全身各个系统，以消化道及其相关来源恶性肿瘤最为多见，占总EPM数量的63．06％。结论胰腺IPMN患者常合并EPM，以消化系统恶性肿瘤居多，提示在该疾病的诊治过程中不应忽视EPM的存在。在随访中，更应警惕新发EPM的可能，且在胰腺IPMN治疗方式的选择方面又增加了一个考虑因素。

Objective To analyse the clinical characteristics of pancreatic mtraductal papillary mucinous neoplasm （IPMN） which coexists with extrapancreatic malignancy （EPM）, with an aim to provide strategies for clinical diagnosis and treatment. Methods The PubMed was used to search for the pancreatic IPMN related articles with positive pathologic results. A pooled analysis was then per- formed. The ratio of pancreatic IPMNs coexisting with EPMs and the locations （or the type） of EPMs were analyzed. Results After a strict process of screening, 18 articles met the pre-determined stand- ards and were accepted. Of the 1327 patients, 363 had coexisting EPMS （27.35%）. There were 392 EPMs in these 363 patients. The EPMs occurred in almost all the systems of the body, especially in the digestive tract and its related organs, which accounted for 63. 06% of the EPMs. Conclusions There is a tendency for patients with pancreatic IPMN to have coexisting EPM. More than half of these EPMs are malignant tumors in the digestive system. When pancreatic IPMN is diagnosed, the clinician should be aware of the possible coexistence of an EPM and should look for the possibility of a new EPM developing in a patient after treatment of pancreatic IPMN.