吸烟及呼吸系统疾病史与需要手术切除的胰腺病变的关联

Association of Smoking and Respiratory Disease History with Pancreatic Pathologies Requiring Surgical Resection.

作者信息

Ream Carolyn, Sabitsky Matthew, Huang Rachel, Hammelef Emma, Yeo Theresa P, Lavu Harish, Yeo Charles J, Bowne Wilbur, Nevler Avinoam

机构信息

Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.

Jefferson Pancreas, Biliary and Related Cancer Center, Department of Surgery, Philadelphia, PA 19107, USA.

出版信息

Cancers (Basel). 2023 May 26;15(11):2935. doi: 10.3390/cancers15112935.

DOI:10.3390/cancers15112935

PMID:37296897

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10251830/

Abstract

BACKGROUND

The purpose of this study was to examine the relationship between various respiratory conditions, including hypercapnic respiratory disease, and a multitude of resected pancreatic lesions.

METHODS

This retrospective case-control study queried a prospectively maintained database of patients who underwent pancreaticoduodenectomy between January 2015 and October 2021. Patient data, including smoking history, medical history, and pathology reports, were recorded. Patients with no smoking history and no concomitant respiratory conditions were designated as the control group.

RESULTS

A total of 723 patients with complete clinical and pathological data were identified. Male current smokers showed increased rates of PDAC (OR 2.33, 95% CI 1.07-5.08, = 0.039). Male patients with COPD had a markedly increased association with IPMN (OR 3.02, CI 1.08-8.41, = 0.039), while females with obstructive sleep apnea had a four-fold increase in risk of IPMN compared to women in the control group (OR 3.89, CI 1.46-10.37, = 0.009). Surprisingly, female patients with asthma had a decreased incidence of pancreatic and periampullary adenocarcinoma (OR 0.36, 95% CI 0.18-0.71. < 0.01).

CONCLUSION

This large cohort study reveals possible links between respiratory pathologies and various pancreatic mass-forming lesions.

摘要

背景

本研究旨在探讨包括高碳酸血症性呼吸疾病在内的各种呼吸疾病与多种切除的胰腺病变之间的关系。

方法

这项回顾性病例对照研究查询了一个前瞻性维护的数据库，该数据库包含2015年1月至2021年10月期间接受胰十二指肠切除术的患者。记录了患者数据，包括吸烟史、病史和病理报告。无吸烟史且无合并呼吸疾病的患者被指定为对照组。

结果

共识别出723例具有完整临床和病理数据的患者。男性当前吸烟者的胰腺导管腺癌发生率增加（比值比2.33，95%置信区间1.07 - 5.08，P = 0.039）。患有慢性阻塞性肺疾病的男性患者与胰腺导管内乳头状黏液瘤的关联显著增加（比值比3.02，置信区间1.08 - 8.41，P = 0.039），而患有阻塞性睡眠呼吸暂停的女性与对照组女性相比，胰腺导管内乳头状黏液瘤的风险增加了四倍（比值比3.89，置信区间1.46 - 10.37，P = 0.009）。令人惊讶的是，患有哮喘的女性患者胰腺和壶腹周围腺癌的发病率降低（比值比0.36，95%置信区间0.18 - 0.71，P < 0.01）。