胰腺导管内乳头状黏液性肿瘤临床特征汇集分析

A pooled analysis on the clinical characteristics of intraductal papillary mucinous neoplasms of the pancre-as

目的探索胰腺导管内乳头状黏液性肿瘤（IPMN）的临床特征，为该疾病的临床诊断提供参考依据。方法以PubMed为检索数据库，对2006年7月1日至2011年6月30日已发表的关于胰腺IPMN文献中经病理学证实的临床病例进行汇集分析，主要内容包括病例的人口统计学信息、主要临床表现、主要相关伴随疾病、肿瘤的形态学类型、解剖学分布特征、病理学类型等。结果共汇集文献123篇，病例6548例。胰腺IPMN多发于老年人，男性较女性略多。胰腺IPMN可发生于胰腺的各个部位，以胰头部多见，其次为胰体一尾部以及弥漫性分布。在其三种形态学类型中，支胰管型最为多见。胰腺IPMN主要临床表现缺乏特异性，以上腹部疼痛、体重减轻及黄疸最为多见。在汇集的病例中，恶性肿瘤病例达半数。结论胰腺IPMN的临床表现缺乏特异性。在临床工作中应警惕胰腺IPMN的存在。应在对其临床特征进行综合分析后，结合患者的自身状况进一步制定治疗方案。

Objective To analyze the clinical characteristics of pancreatic intraductal papillary mucinous neoplasm （IPMN）, which may provide references for its clinical diagnosis and treatment. Methods PubMed was used as a searching database to collect all the pancreatic IPMN related articles with positive pathologic results from July, 2006 to June, 2011. A pooled analysis was then per- formed. The main analysis included demographic information, main clinical manifestations, most asso eiated concomitant diseases, morphology and pathologic types of neoplasms, and characteristics of an- atomical distribution of the lesions. Results 123 articles （including 6548 patients） were collected and analyzed. There was a tendency for the older patients to suffer from pancreatic IPMNs, and males were slightly more than females. In the three types of morphology, the most common was the branch- duct type. Pancreatic IPMNs may appear at any part of the pancreas. The pancreatic head was the most common, followed by the pancreatic body-tail and the diffuse distribution. In all the patients, malignancy was up to half. The main clinical manifestations of pancreatic IPMNs were complete lack of specificity. Upper abdominal pain, weight loss and jaundice were common. Conclusions Particular attention should be paid to the recognition and identification of IPMNs of pancreas as the lesion has nonspecific clinical manifestations. Clinically, treatment should be based on a comprehensive analysis of the clinical features combined with the patienfs general status and intent.