威胁患者生命的并发症主要是肿瘤和小肠梗阻。 因为早期可以出现息肉和肿瘤,强烈推荐监测肠道和肠道外息肉及肿瘤。 小肠梗阻是导致手术的主要原因之一,可以通过切除小肠息肉而使之降到最低。[12]Spigelman AD, Thomson JP, Phillips RK. Towards decreasing the relaparotomy rate in the Peutz-Jeghers syndrome: the role of peroperative small bowel endoscopy. Br J Surg. 1990 Mar;77(3):301-2.http://www.ncbi.nlm.nih.gov/pubmed/2322793?tool=bestpractice.com[22]Oncel M, Remzi FH, Church JM, et al. Benefits of "clean sweep" in Peutz-Jegher's patients. Colorectal Dis. 2004 Sep;6(5):332-5.http://www.ncbi.nlm.nih.gov/pubmed/15335366?tool=bestpractice.com[23]Pennazio M, Rossini FP. Small bowel polyps in Peutz-Jeghers syndrome: management by combined push enteroscopy and intraoperative enteroscopy. Gastrointest Endosc. 2000 Mar;51(3):304-8.http://www.ncbi.nlm.nih.gov/pubmed/10699775?tool=bestpractice.com[24]Edwards DP, Khosraviani K, Stafferton R, et al. Long-term results of polyp clearance by intraoperative enteroscopy in the Peutz-Jeghers syndrome. Dis Colon Rectum. 2003 Jan;46(1):48-50.http://www.ncbi.nlm.nih.gov/pubmed/12544521?tool=bestpractice.com[25]Lin BC, Lien JM, Chen RJ, et al. Combined endoscopic and surgical treatment for the polyposis of Peutz-Jeghers syndrome. Surg Endosc. 2000 Dec;14(12):1185-7.http://www.ncbi.nlm.nih.gov/pubmed/11148795?tool=bestpractice.com[26]Zanoni EC, Averbach M, Borges JL, et al. Laparoscopic treatment of intestinal intussusception in the Peutz-Jeghers syndrome: case report and review of the literature. Surg Laparosc Endosc Percutan Tech. 2003 Aug;13(4):280-2.http://www.ncbi.nlm.nih.gov/pubmed/12960794?tool=bestpractice.com
研究发现与普通人群相比,PJS患者发生肠道和肠外恶性肿瘤的终身风险明显增高;累计终身风险可达93%。[1]Giardiello FM, Bresinger JD, Tersmette AC, et al. Very high risk of cancer in familial Peutz-Jeghers syndrome. Gastroenterology. 2000 Dec;119(6):1447-53.http://www.ncbi.nlm.nih.gov/pubmed/11113065?tool=bestpractice.com 患者应该进行内镜随访和肠外恶性肿瘤随访。 特异性肿瘤的终身风险分别为乳腺癌(50%)、胰腺癌(36%)、卵巢癌(21%)、非小细胞肺癌(15%)、宫颈癌(10%)和子宫癌(9%)。[1]Giardiello FM, Bresinger JD, Tersmette AC, et al. Very high risk of cancer in familial Peutz-Jeghers syndrome. Gastroenterology. 2000 Dec;119(6):1447-53.http://www.ncbi.nlm.nih.gov/pubmed/11113065?tool=bestpractice.com 男性儿童和青少年,以及少量青年男性,也存在睾丸癌的风险。[1]Giardiello FM, Bresinger JD, Tersmette AC, et al. Very high risk of cancer in familial Peutz-Jeghers syndrome. Gastroenterology. 2000 Dec;119(6):1447-53.http://www.ncbi.nlm.nih.gov/pubmed/11113065?tool=bestpractice.com 至今仍然没有证据支持定期监测能够在肿瘤发生率或死亡率方面获益。