目的 探讨胰腺导管内乳头状黏液性肿瘤(IPMN)免疫组织化学类型与病理学类型的关系.方法 检索PubMed全文数据库公开发表的胰腺IPMN临床诊断和治疗的相关文献；检索文献发表时间至201 1年6月30日.采用病例报告质量评估清单对纳入文献进行评分.对胰腺IPMN免疫组织化学类型与性别、病理学类型、肿瘤良恶性特征、形态学类型进行相关性分析.二分类变量采用Pearsonx2检验,多变量相关性分析采用多元回归方程检验.结果 共纳入13篇文献,质量评价得分为31～45分(满分50分),平均得分37分,获得经病理检查确诊的826例胰腺IPMN患者的资料.免疫组织化学分型共4型:(1)胃型患者363例,271例进行性别分析的患者中,男195例、女76例；中位年龄65.6岁.225例进行病理学分型的患者中,腺瘤146例、交界性肿瘤34例、原位癌24例、浸润性癌21例.其中良性肿瘤占86.68％(293/338).215例进行形态学分型的患者中,主胰管型34例、支胰管型151例、混合型30例.(2)肠型患者327例,269例进行性别分析的患者中,男184例、女85例；中位年龄64.5岁.262例进行病理学分型的患者中,腺瘤28例、交界性肿瘤43例、原位癌91例、浸润性癌100例.其中良性肿瘤占29.21％(85/291).151例进行形态学分型的患者中,主胰管型63例、支胰管型54例、混合型34例.(3)胰胆型患者92例,78例进行性别分析的患者中,男41例、女37例；中位年龄69.2岁.81例进行病理学分型的患者中,腺瘤4例、交界性肿瘤1例、原位癌21例、浸润性癌55例,其中良性肿瘤占5.75％(5/87).34例进行形态学分型的患者中,主胰管型7例、支胰管型18例、混合型9例.(4)嗜酸细胞型患者44例,37例进行性别分析的患者中,男24例、女13例；中位年龄60.3岁.33例进行病理学分型的患者中,原位癌18例、浸润性癌15例,均为恶性肿瘤；36例进行形态学分型的患者中,主胰管型9例、支胰管型16例、混合型11例.胰腺IPMN的免疫组织化学类型与性别、病理学类型、肿瘤良恶性存在相关性(x2=10.626,281.839,333.212,r =0.097,0.569,0.625,P＜0.05).虽然胰腺IPMN的免疫组织化学类型与其形态学类型间的Pearson x2检验结果有统计学意义(x2=50.732,P＜0.05),但两者无线性相关性(r=0.010,P＞0.05).结论 胰腺IPMN免疫组织化学类型有其自身特点,与性别、病理学类型、肿瘤良恶性存在相关性,可为治疗及预后评估提供参考.
目的 探討胰腺導管內乳頭狀黏液性腫瘤(IPMN)免疫組織化學類型與病理學類型的關繫.方法 檢索PubMed全文數據庫公開髮錶的胰腺IPMN臨床診斷和治療的相關文獻；檢索文獻髮錶時間至201 1年6月30日.採用病例報告質量評估清單對納入文獻進行評分.對胰腺IPMN免疫組織化學類型與性彆、病理學類型、腫瘤良噁性特徵、形態學類型進行相關性分析.二分類變量採用Pearsonx2檢驗,多變量相關性分析採用多元迴歸方程檢驗.結果 共納入13篇文獻,質量評價得分為31～45分(滿分50分),平均得分37分,穫得經病理檢查確診的826例胰腺IPMN患者的資料.免疫組織化學分型共4型:(1)胃型患者363例,271例進行性彆分析的患者中,男195例、女76例；中位年齡65.6歲.225例進行病理學分型的患者中,腺瘤146例、交界性腫瘤34例、原位癌24例、浸潤性癌21例.其中良性腫瘤佔86.68％(293/338).215例進行形態學分型的患者中,主胰管型34例、支胰管型151例、混閤型30例.(2)腸型患者327例,269例進行性彆分析的患者中,男184例、女85例；中位年齡64.5歲.262例進行病理學分型的患者中,腺瘤28例、交界性腫瘤43例、原位癌91例、浸潤性癌100例.其中良性腫瘤佔29.21％(85/291).151例進行形態學分型的患者中,主胰管型63例、支胰管型54例、混閤型34例.(3)胰膽型患者92例,78例進行性彆分析的患者中,男41例、女37例；中位年齡69.2歲.81例進行病理學分型的患者中,腺瘤4例、交界性腫瘤1例、原位癌21例、浸潤性癌55例,其中良性腫瘤佔5.75％(5/87).34例進行形態學分型的患者中,主胰管型7例、支胰管型18例、混閤型9例.(4)嗜痠細胞型患者44例,37例進行性彆分析的患者中,男24例、女13例；中位年齡60.3歲.33例進行病理學分型的患者中,原位癌18例、浸潤性癌15例,均為噁性腫瘤；36例進行形態學分型的患者中,主胰管型9例、支胰管型16例、混閤型11例.胰腺IPMN的免疫組織化學類型與性彆、病理學類型、腫瘤良噁性存在相關性(x2=10.626,281.839,333.212,r =0.097,0.569,0.625,P＜0.05).雖然胰腺IPMN的免疫組織化學類型與其形態學類型間的Pearson x2檢驗結果有統計學意義(x2=50.732,P＜0.05),但兩者無線性相關性(r=0.010,P＞0.05).結論 胰腺IPMN免疫組織化學類型有其自身特點,與性彆、病理學類型、腫瘤良噁性存在相關性,可為治療及預後評估提供參攷.
목적 탐토이선도관내유두상점액성종류(IPMN)면역조직화학류형여병이학류형적관계.방법 검색PubMed전문수거고공개발표적이선IPMN림상진단화치료적상관문헌；검색문헌발표시간지201 1년6월30일.채용병례보고질량평고청단대납입문헌진행평분.대이선IPMN면역조직화학류형여성별、병이학류형、종류량악성특정、형태학류형진행상관성분석.이분류변량채용Pearsonx2검험,다변량상관성분석채용다원회귀방정검험.결과 공납입13편문헌,질량평개득분위31～45분(만분50분),평균득분37분,획득경병리검사학진적826례이선IPMN환자적자료.면역조직화학분형공4형:(1)위형환자363례,271례진행성별분석적환자중,남195례、녀76례；중위년령65.6세.225례진행병이학분형적환자중,선류146례、교계성종류34례、원위암24례、침윤성암21례.기중량성종류점86.68％(293/338).215례진행형태학분형적환자중,주이관형34례、지이관형151례、혼합형30례.(2)장형환자327례,269례진행성별분석적환자중,남184례、녀85례；중위년령64.5세.262례진행병이학분형적환자중,선류28례、교계성종류43례、원위암91례、침윤성암100례.기중량성종류점29.21％(85/291).151례진행형태학분형적환자중,주이관형63례、지이관형54례、혼합형34례.(3)이담형환자92례,78례진행성별분석적환자중,남41례、녀37례；중위년령69.2세.81례진행병이학분형적환자중,선류4례、교계성종류1례、원위암21례、침윤성암55례,기중량성종류점5.75％(5/87).34례진행형태학분형적환자중,주이관형7례、지이관형18례、혼합형9례.(4)기산세포형환자44례,37례진행성별분석적환자중,남24례、녀13례；중위년령60.3세.33례진행병이학분형적환자중,원위암18례、침윤성암15례,균위악성종류；36례진행형태학분형적환자중,주이관형9례、지이관형16례、혼합형11례.이선IPMN적면역조직화학류형여성별、병이학류형、종류량악성존재상관성(x2=10.626,281.839,333.212,r =0.097,0.569,0.625,P＜0.05).수연이선IPMN적면역조직화학류형여기형태학류형간적Pearson x2검험결과유통계학의의(x2=50.732,P＜0.05),단량자무선성상관성(r=0.010,P＞0.05).결론 이선IPMN면역조직화학류형유기자신특점,여성별、병이학류형、종류량악성존재상관성,가위치료급예후평고제공삼고.
Objective To investigate the relationship between the immunohistochemical types and the pathological types of pancreatic intraductal papillary mucinous neoplasms (IPMN).Methods Literatures on the diagnosis and treatment of pancreatic IPMN published before June 30,2011 in the PubMed database were retrieved.The literatures adopted were scored by the case reports quality assessment list.The correlation analysis between the immunohistochemical types and the gender,pathological types,characteristics of benign or malignant tumor and morphological types were analyzed.All data were analyzed using the Pearson chi-square test or multiple regression analysis.Results Thirteen literatures were adopted,the scores were 31-45 (full mark:50),and the mean score was 37.The clinical data of 826 pancreatic IPMN patients who were comfirmed by pathological examination were collected,and there were 4 immunohistochemical types:(1) The gastric type (363 patients).Of the 271 patients who underwent gender analysis,there were 195 males and 76 females,with the median age of 65.6 years.Of the 225 patients who underwent pathological types analysis,there were 146 cases of adenoma,34 cases of borderline tumor,24 cases of carcinoma in situ,21 cases of invasive carcinoma,the benign tumor was accounted for 86.68％ (293/338).Of the 215 patients who underwent morphological type analysis,there were 34 cases of main pancreatic duct type,151 cases of branch duct type and 30 cases of mixed type.(2) The intestinal type (327 patients).Of the 269 patients who underwent gender analysis,there were 184 males and 85 females,with the median age of 64.5 years.Of the 262 patients who underwent pathological types analysis,there were 28 cases of adenoma,43 cases of borderline tumor,91 cases of carcinoma in situ,100 cases of invasive carcinoma,the benign tumor was accounted for 29.21％ (85/291).Of the 151 patients who underwent morphological type analysis,there were 63 cases of main pancreatic duct type,54 cases of branch duct type and 34 cases of mixed type.(3) The pancreatobiliary type (92 patients).Of the 78 patients who underwent gender analysis,there were 41 males and 37 females,with the median age of 69.2 years.Of the 81 patients who underwent pathological types analysis,there were 4 cases of adenoma,1 case of borderline tumor,21 cases of carcinoma in situ,55 cases of invasive carcinoma,the benign tumor was accounted for 5.75％ (5/87).Of the 34 patients who underwent morphological type analysis,there were 7 cases of main pancreatic duct type,18 cases of branch duct type and 9 cases of mixed type.(4) The oncocytic type (44 patients).Of the 37 patients who underwent gender analysis,there were 24 males and 13 females,with the median age of 60.3 years.Of the 33 patients who underwent pathological types analysis,there were 18 cases of carcinoma in situ,15 cases of invasive carcinoma,and all of them were with malignant tumors.Of the 36 patients who underwent morphological type analysis,there were 9 cases of main pancreatic duct type,16 cases of branch duct type and 11 cases of mixed type.The immunohistochemical type of pancreatic IPMN was correlated with gender,pathological type and characteristics of maglignant or benign tumors (x2=10.626,281.839,333.212,r =0.097,0.569,0.625,P ＜ 0.05).The result of the chi-square test between the immunohistochemical types and the morphological types was statistically significant (x2 =50.732,P ＜ 0.05),but there was no correlation between them (r =0.010,P ＞ 0.05).Conclusion The immunohistochemical type of pancreatic IPMN is correlated with gender,pathological type and the characteristics of maglignant or benign tumors,which provide references for the diagnosis and prognosis evaluation of pancreatic IPMN.
