Gastroenterology:分支导管内乳头状黏液性肿瘤的长期恶化风险

2019-09-03 MedSci MedSci原创

在一项对分支导管IPMNs患者的长期研究中,研究发现胰腺恶性肿瘤的5年发病率为3.3%,在IPMN诊断后15年达到15%

目前,分支导管内乳头状粘液瘤(IPMNs)患者的远期疗效分析尚不充分,近日研究人员分析了近20年IPMN-衍生癌和伴发导管腺癌(PDAC)的发病率。

从1994年到2017年,研究人员在日本东京大学确定了1404名诊断为分支导管IPMN的患者(女性52%,平均年龄67.5岁)。使用竞争风险分析,研究人员估计胰腺癌、全部癌症和癌症类型的累积发生率。研究人员使用竞争风险比例风险模型来估计癌症发病率的亚分布危险比(SHRs)。为了区分IPMN衍生癌和伴发癌,研究人员从现有的IPMNs和癌的配对样本中收集基因组DNA,并通过PCR和焦测序检测GNAS 和 KRAS的突变。

在9231人-年的随访中,研究人员发现68例胰腺癌(38例IPMN-源性癌和30例伴发PDACs),5年、10年和15年的总发病率分别为3.3%、6.6%和15%。在随访5年以上的804例患者中,胰腺癌10年累计发病率为3.5%,自初次诊断起15年累计发病率为12%。IPMN的大小和主胰管直径与IPMN源性癌的发生有关(IPMN大小增加10-mm时:SHR 为1.85;主胰管直径增加1毫米:SHR为1.56),但与伴发PDAC的发生率无关。

在一项对分支导管IPMNs患者的长期研究中,研究发现胰腺恶性肿瘤的5年发病率为3.3%,在IPMN诊断后15年达到15%。

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