Objective: This systematic review and meta-analysis aimed to determine the degree to which pancreaticobiliary maljunction (PBM) increases the risk of different types of biliary cancer (BC). Methods: A systematic review and meta-analysis were carried out using the following databases: PubMed, Embase, Cochrane Library, Scopus, Web of Science, and Science Direct. We systematically searched from inception to April 2024. The search terms included were derived from the keywords “Pancreaticobiliary Maljunction” OR “Anomalous Pancreaticobiliary Junction” AND “Cancer” OR “Malignancy”. Studies that provided data comparing BC rates in relation to PBM presence or vice versa were included. The Newcastle–Ottawa Scale (NOS) was used for quality assessment. The random-effects model was used. Results: Fifteen studies were included with a total sample of 8604 patients, of whom 5015 (58.29%) were female with a mean age of 54.58 years. Patients with PBM had 8.42 (95% CI = 3.57–19.87) more risk of developing any type of BC, with a higher risk of GBC than BDC (OR = 16.91 vs. OR = 3.36,p-value = 0.003). There was a higher risk of having PBM in patients with GBC than BDC only when considering the Asian population (OR = 3.12, 95% CI = 1.09–8.94). Meta-regression analysis revealed that neither mean age (p= 0.087) nor percentage of female patients in the study population (p= 0.197) were statistically associated with the variations in OR for the risk of BC based on the presence of PBM. Conclusions: There is a significant association between PBM and the risk of having BC, mainly GBC when compared to BDC. Most of the studies published reported data from Japanese patients, which limits the generalization of the results. The age of patients and sex were not significantly associated with the relation between PBM and BC. Further prospective studies in broader populations will provide additional details to take measures for screening and early management of PBM and BC.
目的：本系统综述与荟萃分析旨在明确胰胆管合流异常（PBM）对不同类型胆道癌（BC）风险的影响程度。方法：通过检索PubMed、Embase、Cochrane Library、Scopus、Web of Science及Science Direct数据库，系统收集建库至2024年4月的相关文献。检索策略基于"胰胆管合流异常"或"胰胆管连接异常"与"癌症"或"恶性肿瘤"的组合关键词。纳入提供PBM与BC发生率关联数据的研究，采用纽卡斯尔-渥太华量表（NOS）进行质量评估，并使用随机效应模型进行数据分析。结果：共纳入15项研究，总样本量8604例，其中女性5015例（58.29%），平均年龄54.58岁。PBM患者罹患各类BC的总体风险增加8.42倍（95% CI=3.57-19.87），其中胆囊癌（GBC）风险显著高于胆管癌（BDC）（OR=16.91 vs. OR=3.36，p=0.003）。仅在亚洲人群中，GBC患者合并PBM的风险高于BDC患者（OR=3.12，95% CI=1.09-8.94）。荟萃回归分析显示，患者平均年龄（p=0.087）与研究人群女性比例（p=0.197）均未对PBM与BC风险的OR值变异产生显著影响。结论：PBM与BC（尤其是相较于BDC的GBC）风险存在显著关联。现有研究多基于日本人群数据，结论外推性受限。患者年龄与性别在PBM与BC的关联中无显著影响。未来需要在更广泛人群中开展前瞻性研究，为PBM与BC的筛查及早期管理提供更详实的依据。
肿瘤(癌症)患者之家