胰胆管合流异常相关性胆囊癌研究进展

doi:10.16139/j.1007-9610.2024.04.15

摘要/Abstract

摘要：

胰胆管合流异常（PBM）是一种先天性胰胆管畸形，常会引起反复发作的胆管炎、胰腺炎。越来越多的证据表明PBM是一种癌前病变，在胆囊癌（GBC）的发生和发展中起着重要的作用。由PBM所致GBC称为PBM相关性GBC。因此，PBM的早期识别及诊治对于降低GBC的风险至关重要。本文对PBM的概况和诊疗进展以及PBM相关性GBC的临床特征、发生机制及诊疗进展加以综述，旨在显示早期诊治PBM的临床价值，从而降低PBM相关性GBC发生率。

关键词: 胰胆管合流异常, 胆囊癌, 胆道肿瘤

Abstract:

Pancreatobiliary maljunction (PBM) represents a congenital anatomical abnormality of the pancreaticobiliary ductal system, frequently predisposing individuals to recurrent cholangitis and pancreatitis. Accumulating evidence indicates that PBM is a precancerous lesion, and PBM plays an important role in the development and progression of gallbladder cancer (GBC). GBC arising from PBM is designated as PBM-associated GBC. Consequently, early diagnosis and treatment of PBM is paramount in mitigating the risk of GBC. This review outlined the epidemiology and advancements in the diagnosis and management of PBM, along with the clinical features, underlying mechanisms, and therapeutic progressions pertaining to PBM-associated GBC, in order to underscore the clinical significance of early intervention in PBM, so as to reduce the incidence of PBM-associated GBC.

Key words: Pancreaticobiliary maljunction(PBM), Gallbladder cancer(GBC), Biliary tract neoplasm

中图分类号:

马煜博, 李起, 张东, 耿智敏. 胰胆管合流异常相关性胆囊癌研究进展[J]. 外科理论与实践, 2024, 29(04): 365-369.

MA Yubo, LI Qi, ZHANG Dong, GENG Zhimin. Advances in research of pancreaticobiliary maljunction-associated gallbladder cancer[J]. Journal of Surgery Concepts & Practice, 2024, 29(04): 365-369.

参考文献 44

[1]	KAMISAWA T, ANDO H, HAMADA Y, et al. Diagnostic criteria for pancreaticobiliary maljunction 2013[J]. J Hepatobiliary Pancreat Sci, 2014, 21(3):159-161. doi: 10.1002/jhbp.57 pmid: 24307541
[2]	WANG J, MU P, XU Y. Application of imaging techniques in pancreaticobiliary maljunction[J]. World J Clin Cases, 2022, 10(22):7642-7652.
[3]	ROA J C, GARCÍA P, KAPOOR V K, et al. Gallbladder cancer[J]. Nat Rev Dis Primers, 2022, 8(1):69. doi: 10.1038/s41572-022-00398-y pmid: 36302789
[4]	BABBITT D. 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.
[5]	SANADA Y, SAKUMA Y, SATA N. Embryological etio-logy of pancreaticobiliary system predicted from pancreaticobiliary maljunction with incomplete pancreatic divisum: a case report[J]. BMC Surg, 2018, 18(1):50.
[6]	YOSHIMOTO K, KAMISAWA T, KIKUYAMA M, et al. Classification of pancreaticobiliary maljunction and its clinical features in adults[J]. J Hepatobiliary Pancreat Sci, 2019, 26(12):541-547. doi: 10.1002/jhbp.691 pmid: 31633314
[7]	URUSHIHARA N, HAMADA Y, KAMISAWA T, et al. Classification of pancreaticobiliary maljunction and clinical features in children[J]. J Hepatobiliary Pancreat Sci, 2017, 24(8):449-455. doi: 10.1002/jhbp.485 pmid: 28639336
[8]	KIM H J, KIM M H, LEE S K, et al. Normal structure, variations, and anomalies of the pancreaticobiliary ducts of Koreans: a nationwide cooperative prospective study[J]. Gastrointest Endosc, 2002, 55(7):889-896.
[9]	PARLAK E, KÖKSAL A Ş, EMINLER A T, et al. Pancreaticobiliary maljunction in Turkish patients: a multicenter case series[J]. Surg Endosc, 2022, 36(3):2042-2051.
[10]	MURAKI T, PEHLIVANOGLU B, MEMIS B, et al. Pancreatobiliary maljunction-associated gallbladder cancer is as common in the west, shows distinct clinicopathologic characteristics and offers an invaluable model for anatomy-induced reflux-associated physio-chemical carcinogenesis[J]. Ann Surg, 2022, 276(1):e32-e39.
[11]	PAROLINI F, DAVENPORT M. Choledochal malformations and pancreaticobiliary maljunction: a European perspective[M]// KAMISAWAT, ANDOH. Pancreaticobi-liary maljunction and congenital biliary dilatation. Singapore: Springer Singapore,2018:71-79.
[12]	RADKANI P, HAWKSWORTH J, FISHBEIN T. Biliary system[M]// TOWNSENDC M, BEAUCHAMPR D, EVERSB M, et al. Sabiston textbook of surgery:the biological basis of modern surgical practic. 21st ed. Philadelphia: Elsevier Saunders,2022:1505-1506.
[13]	DENG Y L, CHENG N S, LIN Y X, et al. Relationship between pancreaticobiliary maljunction and gallbladder carcinoma: meta-analysis[J]. Hepatobiliary Pancreat Dis Int, 2011, 10(6):570-580.
[14]	KAMISAWA T, MUNAKATA W, TU Y, et al. Sex-based differences in gallbladder cancer associated with pancreaticobiliary maljunction[J]. Hepatogastroenterology, 2008, 55(81):21-23.
[15]	KAMISAWA T, ANDO H, SUYAMA M, et al. Japanese clinical practice guidelines for pancreaticobiliary maljunction[J]. J Gastroenterol, 2012, 47(7):731-759. doi: 10.1007/s00535-012-0611-2 pmid: 22722902
[16]	MA Y, WANG Z, YE M, et al. Transabdominal ultrasound evaluation of pancreaticobiliary maljunction in children[J]. Ultrasound Q, 2022, 38(2):179-184. doi: 10.1097/RUQ.0000000000000585 pmid: 35678481
[17]	ZULFIQAR M, CHATTERJEE D, YONEDA N, et al. Imaging features of premalignant biliary lesions and predisposing conditions with pathologic correlation[J]. Radiographics, 2022, 42(5):1320-1337. doi: 10.1148/rg.210194 pmid: 35930475
[18]	ZHANG J Y, DENG Z H, GONG B. Clinical characteristics and endoscopic treatment of pancreatitis caused by pancreaticobiliary malformation in Chinese children[J]. J Dig Dis, 2022, 23(11):651-659.
[19]	TAKUMA K, KAMISAWA T, TABATA T, et al. Importance of early diagnosis of pancreaticobiliary maljunction without biliary dilatation[J]. World J Gastroenterol, 2012, 18(26):3409-3414.
[20]	KAMISAWA T, KURUMA S, CHIBA K, et al. Biliary carcinogenesis in pancreaticobiliary maljunction[J]. J Gastroenterol, 2017, 52(2):158-163. doi: 10.1007/s00535-016-1268-z pmid: 27704265
[21]	KAWAKAMI S, TAKANO S, FUKASAWA M, et al. Stepwise correlation of TP53 mutations from pancreaticobi-liary maljunction to gallbladder carcinoma: a retrospective study[J]. BMC Cancer, 2021, 21(1):1245.
[22]	KATAOKA F, MIURA S, KUME K, et al. A case of occult pancreaticobiliary reflux due to endoscopically confirmed relaxation of the Oddi sphincter[J]. DEN Open, 2023, 3(1):e161.
[23]	范世光, 雷越, 傅炜昕. 活化诱导的胞苷脱氨酶在肿瘤发生中的作用[J]. 解剖科学进展, 2016, 22(3):337-339.
	FAN S G, LEI Y, FU W X. Role of activation-induced cytidine deaminase in development of tumors[J]. Prog of Anat Sci, 2016, 22(3):337-339.
[24]	MORI H, MASAHATA K, UMEDA S, et al. Risk of carcinogenesis in the biliary epithelium of children with congenital biliary dilatation through epigenetic and genetic regulation[J]. Surg Today, 2022, 52(2):215-223.
[25]	GUO W L, GENG J, ZHAO J G, et al. Gene expression profiling reveals upregulated FUT1 and MYBPC1 in children with pancreaticobiliary maljunction[J]. Braz J Med Biol Res, 2019, 52(8):e8522.
[26]	LOONG J H, WONG T L, TONG M, et al. Glucose deprivation-induced aberrant FUT1-mediated fucosylation drives cancer stemness in hepatocellular carcinoma[J]. J Clin Invest, 2021, 131(11):e143377.
[27]	LIU J, SONG J, LI C. MYBPC1 is a key regulator for laryngeal carcinoma formation[J]. Anticancer Drugs, 2023, 34(1):1-8. doi: 10.1097/CAD.0000000000001313 pmid: 36539363
[28]	YANG A, LIU X, LIU P, et al. LncRNA UCA1 promotes development of gastric cancer via the miR-145/MYO6 axis[J]. Cell Mol Biol Lett, 2021, 26(1):33.
[29]	WANG R, KANG Y, LÖHR C V, et al. Reciprocal regulation of BMF and BIRC5 (Survivin) linked to Eomes overexpression in colorectal cancer[J]. Cancer Lett, 2016, 381(2):341-348. doi: 10.1016/j.canlet.2016.08.008 pmid: 27539959
[30]	KANEKO K, ITO Y, ONO Y, et al. Gene expression profiling reveals upregulated UCA1 and BMF in gallbladder epithelia of children with pancreaticobiliary maljunction[J]. J Pediatr Gastroenterol Nutr, 2011, 52(6):744-750.
[31]	NAGAI M, WATANABE M, IWASE T, et al. Clinical and genetic analysis of noncancerous and cancerous biliary epithelium in patients with pancreaticobiliary maljunction[J]. World J Surg, 2002, 26(1):91-98. pmid: 11898040
[32]	YOSHIDA T, SUGAI T, HABANO W, et al. Microsatellite instability in gallbladder carcinoma: two independent genetic pathways of gallbladder carcinogenesis[J]. J Gastroenterol, 2000, 35(10):768-774. pmid: 11063221
[33]	KOSAKA T, TAJIMA Y, KUROKI T, et al. Helicobacter bilis colonization of the biliary system in patients with pancreaticobiliary maljunction[J]. Br J Surg, 2010, 97(4):544-549. doi: 10.1002/bjs.6907 pmid: 20155791
[34]	TOMIOKA Y, SUNG Y N, SAWADA R, et al. IL-33 overexpression in gallbladder cancers associated with pancreatobiliary maljunction[J]. Histopathology, 2019, 75(3):365-375. doi: 10.1111/his.13863 pmid: 30882917
[35]	AOTA T, TANAKA S, TAKEMURA S, et al. Development of gallbladder cancer during follow-up of pancreaticobiliary maljunction: a report of two cases[J]. J Surg Case Rep, 2022, 2022(12):rjac595.
[36]	李爱武. 腹腔镜下胆总管囊肿切除术中肝总管狭窄或者胆总管远端蛋白栓的处理方法与技巧[J]. 临床小儿外科杂志, 2019, 18(7):545-547.
	LI A W. Handling techniques during laparoscopy of common bile duct cysts with common hepatic stenosis or protein plug of distal common bile duct[J]. J Clin Ped Sur, 2019, 18(7):545-547.
[37]	ZENG J, DENG Z, YANG K, et al. Endoscopic retrograde cholangiopancreatography in children with symptomatic pancreaticobiliary maljunction: a retrospective multicenter study[J]. World J Gastroenterol, 2019, 25(40):6107-6115.
[38]	JIN Z, BIE L, TANG Y. Endoscopic therapy for patients with pancreaticobiliary maljunction: a follow-up study[J]. Oncotarget, 2017, 8(27):44860-44869. doi: 10.18632/oncotarget.16228 pmid: 28415772
[39]	MORINE Y, MORI H, UTSUNOMIYA T, et al. Epide-miology and clinical features of pancreaticobiliary maljunction[J]. J Japan Biliary Assoc, 2011,25:133-140.
[40]	MORINE Y, SHIMADA M, TAKAMATSU H, et al. Clinical features of pancreaticobiliary maljunction: update analysis of 2nd Japan-nationwide survey[J]. J Hepatobiliary Pancreat Sci, 2013, 20(5):472-480. doi: 10.1007/s00534-013-0606-2 pmid: 23579999
[41]	KAMISAWA T, KANEKO K, ITOI T, et al. Pancreaticobiliary maljunction and congenital biliary dilatation[J]. Lancet Gastroenterol Hepatol, 2017, 2(8):610-618.
[42]	KATO H, ASANO Y, ITO M, et al. A case of metachronous intraductal tubulopapillary carcinoma of the pancreas after surgery for gallbladder cancer-accompanied pancreaticobiliary maljunction[J]. Clin J Gastroenterol, 2022, 15(5):1018-1025.
[43]	ONISHI S, YAMADA K, MURAKAMI M, et al. Co-injection of bile and indocyanine green for detecting pancreaticobiliary maljunction of choledochal cyst[J]. Eur J Pediatr Surg Rep, 2022, 10(01):e127-e130.
[44]	IHN K, HO I G, HONG Y J, et al. Changes in outcomes and operative trends with pediatric robot-assisted resection of choledochal cyst[J]. Surg Endosc, 2022, 36(4):2697-2704.