臨床外科70巻12号

2015年11月発行

特集 同時性・異時性の重複がんを見落とさない—がん診療における他臓器への目配り 同時性・異時性重複がんの実態と診療戦略

膵癌・IPMN

著者： 宮坂義浩¹ 大塚隆生¹ 森泰寿¹ 中村雅史¹

所属機関： ¹九州大学大学院医学研究院臨床・腫瘍外科

ページ範囲：P.1365 - P.1368

【ポイント】
◆膵癌の他臓器癌の発生頻度は一般人口における癌発生頻度とほぼ同等で，胃癌，大腸癌，乳癌などが多い．
◆膵管内乳頭粘液性腫瘍（IPMN）は他臓器癌合併の頻度が高いという報告が多いが，一方で一般人口と同等という報告もある．
◆IPMN患者では通常型膵癌の発生頻度が一般人口の9〜26倍高い．

参考文献

1）Katanoda K, Hori M, Matsuda T, et al：An update report on the trends in cancer incidence and mortality in Japan, 1958-2013. Jpn J Clin Oncol 45：390-401, 2015

2）Choi MG, Kim SW, Han SS, et al：High incidence of extrapancreatic neoplasms in patients with intraductal papillary mucinous neoplasms. Arch Surg 141：51-56, 2006

3）Eguchi H, Ishikawa O, Ohigashi H, et al：Patients with pancreatic intraductal papillary mucinous neoplasms are at high risk of colorectal cancer development. Surgery 139：749-754, 2006

4）Hackert T, Tjaden C, Muller S, et al：Extrapancreatic malignancies in patients with pancreatic cancer：epidemiology and clinical consequences. Pancreas 41：212-217, 2012

5）Lubezky N, Ben-Haim M, Lahat G, et al：Intraductal papillary mucinous neoplasm of the pancreas：associated cancers, family history, genetic predisposition? Surgery 151：70-75, 2012

6）Riall TS, Stager VM, Nealon WH, et al：Incidence of additional primary cancers in patients with invasive intraductal papillary mucinous neoplasms and sporadic pancreatic adenocarcinomas. J Am Coll Surg 204：803-813, 2007

7）Sugiyama M, Atomi Y：Extrapancreatic neoplasms occur with unusual frequency in patients with intraductal papillary mucinous tumors of the pancreas. Am J Gastroenterol 94：470-473, 1999

8）澄井俊彦，田中不二雄，阿部恵子，他：膵癌と他臓器癌を合併した重複癌症例に関する検討．臨と研77：2129-2131，2000

9）田中雅夫：膵癌登録報告2007．膵臓22：e1-427，2007

10）清水京子：【膵臓症候群（第2版）—その他の膵臓疾患を含めて】その他の膵症候群および膵疾患に伴う病態．遺伝性膵癌症候群．日臨（別冊）：446-449，2011

11）Amin S, McBride RB, Kline JK, et al：Incidence of subsequent pancreatic adenocarcinoma in patients with a history of nonpancreatic primary cancers. Cancer 118：1244-1251, 2012

12）Baumgaertner I, Corcos O, Couvelard A, et al：Prevalence of extrapancreatic cancers in patients with histologically proven intraductal papillary mucinous neoplasms of the pancreas：a case-control study. Am J Gastroenterol 103：2878-2882, 2008

13）Kawakubo K, Tada M, Isayama H, et al：Incidence of extrapancreatic malignancies in patients with intraductal papillary mucinous neoplasms of the pancreas. Gut 60：1249-1253, 2011

14）Larghi A, Panic N, Capurso G, et al：Prevalence and risk factors of extrapancreatic malignancies in a large cohort of patients with intraductal papillary mucinous neoplasm（IPMN）of the pancreas. Ann Oncol 24：1907-1911, 2013

15）Malleo G, Marchegiani G, Borin A, et al：Observational study of the incidence of pancreatic and extrapancreatic malignancies during surveillance of patients with branch-duct intraductal papillary mucinous neoplasm. Ann Surg 261：984-990, 2015

16）Ohtsuka T, Kono H, Tanabe R, et al：Follow-up study after resection of intraductal papillary mucinous neoplasm of the pancreas；special references to the multifocal lesions and development of ductal carcinoma in the remnant pancreas. Am J Surg 204：44-48, 2012

17）Yoon WJ, Ryu JK, Lee JK, et al：Extrapancreatic malignancies in patients with intraductal papillary mucinous neoplasm of the pancreas：prevalence, associated factors, and comparison with patients with other pancreatic cystic neoplasms. Ann Surg Oncol 15：3193-3198, 2008

18）小山内学，丹野誠志，中野靖弘，他：膵管内乳頭腫瘍における他臓器癌合併例の検討．切除例と経過観察例を含む148例の検討．膵臓18：565-569，2003

19）Reid-Lombardo KM, Mathis KL, Wood CM, et al：Frequency of extrapancreatic neoplasms in intraductal papillary mucinous neoplasm of the pancreas：implications for management. Ann Surg 251：64-69, 2010

20）Maire F, Hammel P, Terris B, et al：Intraductal papillary and mucinous pancreatic tumour：a new extracolonic tumour in familial adenomatous polyposis. Gut 51：446-449, 2002

21）Sparr JA, Bandipalliam P, Redston MS, et al：Intraductal papillary mucinous neoplasm of the pancreas with loss of mismatch repair in a patient with Lynch syndrome. Am J Surg Pathol 33：309-312, 2009

22）Yamaguchi K, Ohuchida J, Ohtsuka T, et al：Intraductal papillary-mucinous tumor of the pancreas concomitant with ductal carcinoma of the pancreas. Pancreatology 2：484-490, 2002

23）Yamaguchi K, Kanemitsu S, Hatori T, et al：Pancreatic ductal adenocarcinoma derived from IPMN and pancreatic ductal adenocarcinoma concomitant with IPMN. Pancreas 40：571-580, 2011

24）Uehara H, Nakaizumi A, Ishikawa O, et al：Development of ductal carcinoma of the pancreas during follow-up of branch duct intraductal papillary mucinous neoplasm of the pancreas. Gut 57：1561-1565, 2008