Departments of Cancer Survey, Cancer Control and Statistics, and Gastroenterology, Osaka Medical Center for Cancer & CVD, 1-3-3 Nakamichi, Higashinari, Osaka 537-8511, Japan.
Radiology. 2010 Mar;254(3):965-72. doi: 10.1148/radiol.09090992.
To prospectively determine whether slight dilatation of the main pancreatic duct and pancreatic cysts detected at ultrasonography (US) are predictive signs of pancreatic cancer.
The research protocol was approved by the institutional review board, and written informed consent was obtained from all participants. One thousand fifty-eight subjects (age range, 36-80 years; mean, 61.8 years) with various kinds of abnormal US findings in the pancreas were enrolled from 1999 to 2002, after exclusion of pancreatic neoplasm and other malignant diseases. The endpoint was the subsequent development of pancreatic cancer, and the outcome was determined at the end of December 2007. To identify independent predictive variables for the subsequent development of pancreatic cancer, various baseline characteristics were examined by using a Cox regression model and a Cox proportional hazards model. The cumulative incidence of pancreatic cancer was estimated by using the Kaplan-Meyer method.
During the mean follow-up of 75.5 months (+/- 17.3[standard deviation]), pancreatic cancer subsequently developed in 12 of 1058 subjects. The risk of pancreatic cancer was significantly elevated in subjects with slight dilatation (> or = 2.5 mm) of the main pancreatic duct or presence of cyst (s) (> or = 5 mm). The respective hazard ratios were 6.38 (P = .018) and 6.23 (P = .003). For subjects with both findings, the 5-year cumulative risk of pancreatic cancer was 5.62% (95% confidence interval: .37%, 13.03%), and the age-and sex-adjusted hazard ratio compared with the risk in the absence of these findings was 27.50 (P = .002).
Main pancreatic duct dilatation (> or = 2.5 mm) and presence of a pancreatic cyst (> or = 5 mm) were both strong independent predictors of the subsequent development of pancreatic cancer. (c) RSNA, 2010.
前瞻性地确定超声检查（US）发现的主胰管轻度扩张和胰腺囊肿是否为胰腺癌的预测指标。
本研究方案经机构审查委员会批准，并获得所有参与者的书面知情同意。从 1999 年至 2002 年，共纳入 1058 例各种异常 US 发现的胰腺患者（年龄 36-80 岁，平均 61.8 岁），排除了胰腺肿瘤和其他恶性疾病。终点是胰腺癌的后续发展，结局在 2007 年 12 月底确定。为了确定后续发生胰腺癌的独立预测变量，使用 Cox 回归模型和 Cox 比例风险模型检查各种基线特征。使用 Kaplan-Meier 方法估计胰腺癌的累积发生率。
在平均 75.5 个月（+/- 17.3[标准差]）的随访中，1058 例患者中有 12 例随后发生胰腺癌。主胰管轻度扩张（>或=2.5mm）或存在囊肿（s）（>或=5mm）的患者发生胰腺癌的风险显著增加。相应的风险比分别为 6.38（P =.018）和 6.23（P =.003）。对于同时存在这两种发现的患者，5 年胰腺癌累积风险为 5.62%（95%置信区间：.37%，13.03%），与无这些发现相比，年龄和性别调整后的风险比为 27.50（P =.002）。
主胰管扩张（>或=2.5mm）和胰腺囊肿存在（>或=5mm）均为胰腺癌后续发生的强独立预测指标。（c）RSNA，2010 年。
