目的探讨胰腺实性假乳头状瘤(SPN)患者术后复发的危险因素。方法计算机检索中国知网、万方医学网、维普网、PubMed、Web of Science、Embase数据库,筛选有关SPN患者术后复发危险因素的病例-对照研究,检索时限均自数据库建立至2022年11月。由两名研究者按照纳入与排除标准对所搜集文献进行独立筛选、资料提取和方法学质量评价后,采用RevMan 5.4软件进行统计分析,用比值比(OR)和95%可信区间(CI)描述。结果最终共纳入14篇文献,包含1409例研究对象,其中复发组67例,未复发组1342例。从文献中提取对SPN术后复发有预测价值的12个危险因素,荟萃分析结果显示各因素的合并OR值及95%CI:性别(OR=0.75,95%CI:0.35~1.59,P=0.450)、年龄(OR=-2.08,95%CI:-5.24~1.08,P=0.200)、肿瘤长径(OR=5.29,95%CI:4.71~5.87,P<0.001)、肿瘤位置(OR=0.56,95%CI:0.28~1.13,P=0.100)、同步转移(OR=86.84,95%CI:22.64~333.05,P<0.001)、淋巴结转移(OR=7.55,95%CI:2.58~22.06,P<0.001)、神经鞘膜侵犯(OR=2.10,95%CI:0.98~4.48,P=0.060)、切缘阳性(OR=7.00,95%CI:2.56~19.15,P<0.001)、钙化(OR=0.49,95%CI:0.11~2.23,P=0.360)、淋巴血管侵犯(OR=11.22,95%CI:4.81~26.18,P<0.001)、胰周软组织侵犯(OR=1.38,95%CI:0.48~4.00,P=0.550)、包膜侵犯(OR=1.72,95%CI:0.53~5.65,P=0.370)。结论肿瘤长径较大、同步转移、淋巴结转移、切缘阳性、淋巴血管侵犯等因素增加SPN切除后复发的风险,有上述特征的患者应该接受长期随访。
胰腺癌是高度恶性的消化系统肿瘤,早期难以诊断且预后不良。全球胰腺癌五年生存率一直低于5%。尽管有多种治疗方法,但碘125粒子植入因其独特优势而备受关注,故对碘125粒子植入在不可切除胰腺癌中的疗效和安全性展开综述。CT引导下经皮粒子植入具有手术时间短、出血少、恢复快、并发症少且医疗费用低的优势。研究表明,该技术能有效控制肿瘤生长,缓解疼痛,延长寿命。碘125粒子植入可单独或与其他疗法结合使用,但需统一剂量和程序以指导临床实践。Pancreatic cancer is a highly malignant digestive system tumor that is difficult to diagnose in its early stages and has a poor prognosis. The five-year survival rate for pancreatic cancer worldwide is less than 5%. Despite various treatment options, iodine-125 (I-125) seed implantation has garnered considerable attention due to its unique advantages, so a systematic review of the efficacy and safety of I-125 seed implantation in unresectable pancreatic cancer is conducted. Percutaneous seed implantation under CT or ultrasound guidance has the advantages of short operation time, minimal bleeding, fast recovery, fewer complications, and lower medical costs. Studies have shown that this technology can effectively control tumor growth, alleviate pain, and prolong survival. I-125 seed implantation can be used alone or in combination with other therapies, but a uniform dose and protocol should be followed to guide clinical practice.
