Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Gastroenterol. 2017 Aug;52(8):992-1000. doi: 10.1007/s00535-017-1311-8. Epub 2017 Jan 27.
The world's first diagnostic criteria for early CP were proposed in 2009 in Japan. This study aimed to clarify the clinico-epidemiological features of early CP in Japan.
Patients with early CP who were diagnosed according to the diagnostic criteria for early CP and had visited the selected hospitals in 2011 were surveyed. The study consisted of two-stage surveys: the number of patients with early CP was estimated by the first questionnaire and their clinical features were assessed by the second questionnaire.
The estimated number of early CP patients was 5410 (95% confidence interval 3675-6945), with an overall prevalence of 4.2 per 100,000 persons. The number of patients who were newly diagnosed with early CP was estimated to be 1330 (95% confidence interval 1058-1602), with an annual incidence of 1.0 per 100,000 persons. Detailed clinical information was obtained in 151 patients in the second survey. The male-to-female sex ratio was 1.32:1. The mean age was 60.4 and the mean age at disease onset was 55.4. Idiopathic (47.7%) and alcoholic (45.0%) were the two most common etiologies. Proportions of female and idiopathic cases were higher in early CP than in definite CP. Hyperechoic foci without shadowing and stranding were the most common findings on endoscopic ultrasonography. The clinical profiles of early CP patients who showed lobularity with honeycombing on endoscopic ultrasonography or previous episodes of acute pancreatitis were similar to those of definite CP patients.
We clarified the current status of early CP in Japan.
世界上首个早期慢性胰腺炎(CP)的诊断标准于 2009 年在日本提出。本研究旨在阐明日本早期 CP 的临床流行病学特征。
根据早期 CP 的诊断标准诊断为早期 CP 并于 2011 年访问选定医院的患者接受了调查。该研究包括两阶段调查:通过第一份问卷估计早期 CP 患者的数量,并通过第二份问卷评估其临床特征。
估计早期 CP 患者为 5410 例(95%置信区间 3675-6945),总体患病率为每 100000 人 4.2 例。新诊断为早期 CP 的患者数量估计为 1330 例(95%置信区间 1058-1602),年发病率为每 100000 人 1.0 例。在第二份调查中,详细的临床信息获得了 151 例患者。男女比例为 1.32:1。平均年龄为 60.4 岁,发病年龄平均为 55.4 岁。特发性(47.7%)和酒精性(45.0%)是最常见的两个病因。女性和特发性病例在早期 CP 中的比例高于明确 CP。内镜超声检查最常见的表现为无阴影和条索状的高回声灶。内镜超声检查显示有分叶伴蜂巢状改变或既往有急性胰腺炎发作的早期 CP 患者的临床特征与明确 CP 患者相似。
我们阐明了日本早期 CP 的现状。