粘液性胰腺囊性肿瘤恶性转化的预测因素：系统回顾与荟萃分析

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford Pub Date : 2024-10-04 DOI:10.1016/j.suronc.2024.102153

Paola Solis- Pazmino , Camila Pazmino , Orly Termeie , Kristina La , Eduardo Pilatuna , Belen Tite , Luis Figueroa , Magno Guarconi , Jon Harrison , Yosef Nasseri , Joshua Ellenhorn , Brendan C. Visser

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引用次数: 0

摘要

背景卵巢型基质的存在定义了粘液性囊肿（MCN）。目前的共识指南（IAP、AGA 和欧洲）对手术切除的标准各有不同。本荟萃分析旨在描述可预测胰腺MCN恶性转化的术前临床参数。方法对2006年至2022年12月手稿撰写期间发表的文章进行系统回顾和荟萃分析。电子数据库包括Ovid MEDLINE In-Process & Other Non-Indexed Citations、Ovid MEDLINE、Ovid EMBASE和Scopus中的英文出版物。结果确定了17项研究，纳入了1058名接受胰腺切除术治疗的MCN患者。患者的平均年龄为 48.2 岁（标准差 [SD] ± 7.9），预计女性占多数（96%）。大多数患者的主要症状是腹痛（55.6%），但也有近 20% 的患者无症状。大多数患者接受了胰腺远端切除术（70.5%），肿瘤平均大小为 45 毫米。浸润性癌症发生率为 13.8%。与没有壁结节的囊肿相比，有壁结节的囊肿发生浸润性肿瘤的风险更高（OR 26.47，95%CI 12.57-55.74，p <0.001，I2:0 %）。其他临床因素，如壁内钙化或血清 CA 19-9 升高（>37U/mL）并不能预测恶变。它可作为治疗决策的一个标准。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Predictors of malignant transformation in mucinous pancreatic cystic neoplasm: A systemic review and meta-analysis

Background

The presence of ovarian-type stroma defines mucinous cystic neoplasm (MCN). Criteria for surgical resection differ between current consensus guidelines (IAP, AGA, and Europe). This meta-analysis aims to describe pre-surgical clinical parameters that predict malignant transformation of MCN of the pancreas.

Methods

A systematic review and meta-analysis of articles published from 2006 to the time of manuscript authorship in December 2022. The electronic databases included English publications in Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, and Scopus.

Results

17 studies were identified and included 1058 patients with MCN treated with pancreatectomy. The mean cohort age was 48.2 years (standard deviation [SD] ± 7.9) with an expected female predominance (96 %). The presenting symptom for most was abdominal pain (55.6 %), however, nearly 20 % of patients were asymptomatic. Most patients were treated with distal pancreatectomy (70.5 %), and the mean tumor size was 45 mm. The rate of invasive cancer was 13.8 %. Cysts with mural nodules had a higher risk of developing invasive tumors than those that did not (OR 26.47, 95%CI 12.57–55.74, p < 0.001, I2:0 %). Other clinical factors such as the presence of intramural calcifications or an elevated serum CA 19–9 (>37U/mL) were not predictive of malignancy.

Conclusion

The present meta-analysis did not clarify establishing reliable predictors for malignant transformation other than mural modularity, which may represent tumors that have already undergone transformation. It may be used as a criterion in treatment decision-making.

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来源期刊

Surgical Oncology-Oxford 医学-外科

CiteScore

4.50

自引率

0.00%

发文量

169

审稿时长

38 days

期刊介绍： Surgical Oncology is a peer reviewed journal publishing review articles that contribute to the advancement of knowledge in surgical oncology and related fields of interest. Articles represent a spectrum of current technology in oncology research as well as those concerning clinical trials, surgical technique, methods of investigation and patient evaluation. Surgical Oncology publishes comprehensive Reviews that examine individual topics in considerable detail, in addition to editorials and commentaries which focus on selected papers. The journal also publishes special issues which explore topics of interest to surgical oncologists in great detail - outlining recent advancements and providing readers with the most up to date information.