Association between Pancreaticobiliary Maljunction and Gallbladder Carcinoma: A Meta-Analysis_West China Medical Journal

Authors：

DENG Daian ¹ , YE Hui ² , CHENG Nansheng ² , DAI Qiang ¹ , JIANG Wu ¹ , ZHANG Tao ¹

. 1. The First People’s Hospital of Anyue County, Anyue, Sichuan 642350, P. R. China; 2. Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

Keywords：

胰胆管合流异常; 胆囊癌; Meta分析

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目的　综合评价胰胆管合流异常（PBM）与胆囊癌发生的关系，为胆囊癌的预防提供更多、更准确的信息。方法　计算机检索中国生物医学文献数据库（CBM）、中国期刊网（CNKI）、PubMed、EMBASE、万方等数据库，检索时间从1977年4月－2011年5月，并结合文献追溯的方法，收集国内外公开发表的关于PBM与胆囊癌关系的病例对照研究或队列研究，采用RevMan 5.0.25软件进行Meta分析。结果　总计纳入文献8篇，其中3篇仅对比分析了PBM在胆囊癌患者与正常对照组中发生率的差异，2篇仅对比分析了胆囊癌在PBM患者与正常对照组中发生率的差异，而另外3篇文献则对这两种发生率的差异都进行了对比。Meta分析结果显示：胆囊癌患者中PBM的发生率明显高于正常对照组，差异有统计学意义[OR=7.41，95%CI（5.03，10.87），P＜0.000 01]；且PBM患者中胆囊癌的发生率明显高于正常对照组，差异有统计学意义[OR=17.67，95%CI（10.43，29.94），P＜0.000 01]。结论　PBM是胆囊癌发生的高危因素，与胆囊癌的发生密切相关。

Citation： DENG Daian,YE Hui,CHENG Nansheng,DAI Qiang,JIANG Wu,ZHANG Tao. Association between Pancreaticobiliary Maljunction and Gallbladder Carcinoma: A Meta-Analysis. West China Medical Journal, 2012, 27(8): 1162-1167. doi: Copy

1.	Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012[J]. CA Cancer J Clin, 2006, 62(1): 10-29.
2.	Dowling GP, Kelly JK. The histogenesis of adenocarcinoma of the gallbladder[J]. Cancer, 1986, 58(8): 1702-1708.
3.	Randi G, Franceschi S, La Vecchia C. Gallbladder cancer worldwide: geographical distribution and risk factors[J]. Int J Cancer, 2006, 118(7): 1591-1602.
4.	The Japanese Study Group on Pancreaticobiliary Maljunction. Diagnostic criteria of pancreaticobiliary maljunction[J]. J Hepatobiliary Pancreat Surg, 1994, 1(2): 219-221.
5.	Kimura K, Ohto M, Saisho H, et al. Association of gallbladder carcinoma and anomalous pancreaticobiliary ductal union[J]. Gastroenterology, 1985, 89(6): 1258-1265.
6.	杨明, 乔岐禄. 胰胆管合流异常的研究进展[J]. 世界华人消化杂志, 2008, 16(11): 1215-1219.
7.	胡冰, 周岱云, 吴萍, 等. 先天性胆胰管合流异常与胆囊癌的关联[J]. 中华消化内镜杂志, 2004, 21(4): 225-228.
8.	Wang HP, Wu MS, Lin CC, et al. Pancreaticobiliary diseases associated with anomalous pancreaticobiliary ductal union[J]. Gastrointest Endosc, 1998, 48(2): 184-189.
9.	Kang CM, Kim KS, Choi JS, et al. Gallbladder carcinoma associated with anomalous pancreaticobiliary duct junction[J]. Can J Gastroenterol, 2007, 21(6): 383-387.
10.	Chijiiwa K, Tanaka M, Nakayama F. Adenocarcinoma of the gallbladder associated with anomalous pancreaticobiliary ductal junction[J]. Am Surg, 1993, 59(7): 430-434.
11.	Roukounakis N, Manolakopoulos S, Tzourmakliotis D, et al. Biliary tract malignancy and abnormal pancreaticobiliary junction in a Western population[J]. J Gastroenterol Hepatol, 2007, 22(11): 1949-1952.
12.	Misra SP, Dwivedi M. Pancreaticobiliary ductal union[J]. Gut, 1990, 31(10): 1144-1149.
13.	王亚东, 王作仁, 王林, 等. 胰胆管合流异常与胆囊癌[J]. 中华肝胆外科杂志, 1998, 4(1): 31-33.
14.	Lichtenstein MJ, Cynthia DM, Elwood PC. Guidelines for reading case-control studies[J]. J Chronic Dis, 1987, 40(9): 893-903.
15.	Babbitt DP. Congenital choledochal cysts: new etiological concept based on anomalous relationships of the common bile duct and pancreatic bulb[J]. Ann Radiol (Paris), 1969, 12(3): 231-240.
16.	Hanada K, Itoh M, Fujii K, et al. K-ras and p53 mutations in stage I gallbladder carcinoma with an anomalous junction of the pancreaticobiliary duct[J]. Cancer, 1996, 77(3): 452-458.
17.	Hanada K, Tsuchida A, Iwao T, et al. Gene mutations of K-ras in gallbladder mucosae and gallbladder carcinoma with an anomalous junction of the pancreaticobiliary duct[J]. Am J Gastroenterol, 1999, 94(6): 1638-1642.
18.	Tanno S, Obara T, Fujii T, et al. Proliferative potential and K-ras mutation in epithelial hyperplasia of the gallbladder in patients with anomalous pancreaticobiliary ductal union[J]. Cancer, 1998, 83(2): 267-275.
19.	Mizuno M, Kato T, Koyama K. An analysis of mutagens in the contents of the biliary tract in pancreaticobiliary maljunction[J]. Surg Today, 1996, 26(8): 597-602.
20.	Isozaki H, Okajima K, Hara H, et al. Proliferating cell nuclear antigen expression in the gallbladder with pancreaticobiliary maljunction[J]. J Surg Oncol, 1997, 65(1): 46-49.
21.	Ono S, Tokiwa K, Iwai N. Cellular activity in the gallbladder of children with anomalous arrangement of the pancreaticobiliary duct[J]. J Pediatr Surg, 1999, 34(6): 962-966.
22.	Tanno S, Obara T, Maguchi H, et al. Thickened inner hypoechoic layer of the gallbladder wall in the diagnosis of anomalous pancreaticobiliary ductal union with endosonography[J]. Gastrointest Endosc, 1997, 46(6): 520-526.
23.	Kamisawa T, Honda G, Kurata M, et al. Pancreatobiliary disorders associated with pancreaticobiliary maljunction[J]. Dig Surg, 2010, 27(2): 100-104.
24.	Ohuchida J, Chijiiwa K, Hiyoshi M, et al. Long-term results of treatment for pancreaticobiliary maljunction without bile duct dilatation[J]. Arch Surg, 2006, 141(11): 1066-1070.

1. 　Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012[J]. CA Cancer J Clin, 2006, 62(1): 10-29.
2. 　Dowling GP, Kelly JK. The histogenesis of adenocarcinoma of the gallbladder[J]. Cancer, 1986, 58(8): 1702-1708.
3. 　Randi G, Franceschi S, La Vecchia C. Gallbladder cancer worldwide: geographical distribution and risk factors[J]. Int J Cancer, 2006, 118(7): 1591-1602.
4. 　The Japanese Study Group on Pancreaticobiliary Maljunction. Diagnostic criteria of pancreaticobiliary maljunction[J]. J Hepatobiliary Pancreat Surg, 1994, 1(2): 219-221.
5. 　Kimura K, Ohto M, Saisho H, et al. Association of gallbladder carcinoma and anomalous pancreaticobiliary ductal union[J]. Gastroenterology, 1985, 89(6): 1258-1265.
6. 　杨明, 乔岐禄. 胰胆管合流异常的研究进展[J]. 世界华人消化杂志, 2008, 16(11): 1215-1219.
7. 　胡冰, 周岱云, 吴萍, 等. 先天性胆胰管合流异常与胆囊癌的关联[J]. 中华消化内镜杂志, 2004, 21(4): 225-228.
8. 　Wang HP, Wu MS, Lin CC, et al. Pancreaticobiliary diseases associated with anomalous pancreaticobiliary ductal union[J]. Gastrointest Endosc, 1998, 48(2): 184-189.
9. 　Kang CM, Kim KS, Choi JS, et al. Gallbladder carcinoma associated with anomalous pancreaticobiliary duct junction[J]. Can J Gastroenterol, 2007, 21(6): 383-387.
10. 　Chijiiwa K, Tanaka M, Nakayama F. Adenocarcinoma of the gallbladder associated with anomalous pancreaticobiliary ductal junction[J]. Am Surg, 1993, 59(7): 430-434.
11. 　Roukounakis N, Manolakopoulos S, Tzourmakliotis D, et al. Biliary tract malignancy and abnormal pancreaticobiliary junction in a Western population[J]. J Gastroenterol Hepatol, 2007, 22(11): 1949-1952.
12. 　Misra SP, Dwivedi M. Pancreaticobiliary ductal union[J]. Gut, 1990, 31(10): 1144-1149.
13. 　王亚东, 王作仁, 王林, 等. 胰胆管合流异常与胆囊癌[J]. 中华肝胆外科杂志, 1998, 4(1): 31-33.
14. 　Lichtenstein MJ, Cynthia DM, Elwood PC. Guidelines for reading case-control studies[J]. J Chronic Dis, 1987, 40(9): 893-903.
15. 　Babbitt DP. Congenital choledochal cysts: new etiological concept based on anomalous relationships of the common bile duct and pancreatic bulb[J]. Ann Radiol (Paris), 1969, 12(3): 231-240.
16. 　Hanada K, Itoh M, Fujii K, et al. K-ras and p53 mutations in stage I gallbladder carcinoma with an anomalous junction of the pancreaticobiliary duct[J]. Cancer, 1996, 77(3): 452-458.
17. 　Hanada K, Tsuchida A, Iwao T, et al. Gene mutations of K-ras in gallbladder mucosae and gallbladder carcinoma with an anomalous junction of the pancreaticobiliary duct[J]. Am J Gastroenterol, 1999, 94(6): 1638-1642.
18. 　Tanno S, Obara T, Fujii T, et al. Proliferative potential and K-ras mutation in epithelial hyperplasia of the gallbladder in patients with anomalous pancreaticobiliary ductal union[J]. Cancer, 1998, 83(2): 267-275.
19. 　Mizuno M, Kato T, Koyama K. An analysis of mutagens in the contents of the biliary tract in pancreaticobiliary maljunction[J]. Surg Today, 1996, 26(8): 597-602.
20. 　Isozaki H, Okajima K, Hara H, et al. Proliferating cell nuclear antigen expression in the gallbladder with pancreaticobiliary maljunction[J]. J Surg Oncol, 1997, 65(1): 46-49.
21. 　Ono S, Tokiwa K, Iwai N. Cellular activity in the gallbladder of children with anomalous arrangement of the pancreaticobiliary duct[J]. J Pediatr Surg, 1999, 34(6): 962-966.
22. 　Tanno S, Obara T, Maguchi H, et al. Thickened inner hypoechoic layer of the gallbladder wall in the diagnosis of anomalous pancreaticobiliary ductal union with endosonography[J]. Gastrointest Endosc, 1997, 46(6): 520-526.
23. 　Kamisawa T, Honda G, Kurata M, et al. Pancreatobiliary disorders associated with pancreaticobiliary maljunction[J]. Dig Surg, 2010, 27(2): 100-104.
24. 　Ohuchida J, Chijiiwa K, Hiyoshi M, et al. Long-term results of treatment for pancreaticobiliary maljunction without bile duct dilatation[J]. Arch Surg, 2006, 141(11): 1066-1070.

West China Medical Journal

Association between Pancreaticobiliary Maljunction and Gallbladder Carcinoma: A Meta-Analysis

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