急性胰腺炎首次发作后患胰腺癌的风险。

Risk of Pancreatic Cancer After a Primary Episode of Acute Pancreatitis.

作者信息

Rijkers Anton P, Bakker Olaf J, Ahmed Ali Usama, Hagenaars Julia C J P, van Santvoort Hjalmar C, Besselink Marc G, Bollen Thomas L, van Eijck Casper H

机构信息

From the *Department of Surgery, Erasmus MC, University Medical Center, Rotterdam; †Department of Surgery, University Medical Center, Utrecht; ‡Department of Surgery, Maasstad Hospital, Rotterdam; §Department of Surgery, Academic Medical Center, Amsterdam; and ∥Department of Radiology, St Antonius Hospital, Nieuwegein, The Netherlands.

出版信息

Pancreas. 2017 Sep;46(8):1018-1022. doi: 10.1097/MPA.0000000000000879.

DOI:10.1097/MPA.0000000000000879

PMID:28797012

Abstract

OBJECTIVE

Acute pancreatitis may be the first manifestation of pancreatic cancer. The aim of this study was to assess the risk of pancreatic cancer after a first episode of acute pancreatitis.

METHODS

Between March 2004 and March 2007, all consecutive patients with a first episode of acute pancreatitis were prospectively registered. Follow-up was based on hospital records audit, radiological imaging, and patient questionnaires. Outcome was stratified based on the development of chronic pancreatitis.

RESULTS

We included 731 patients. The median follow-up time was 55 months. Progression to chronic pancreatitis was diagnosed in 51 patients (7.0%). In this group, the incidence rate per 1000 person-years for developing pancreatic cancer was 9.0 (95% confidence interval, 2.3-35.7). In the group of 680 patients who did not develop chronic pancreatitis, the incidence rate per 1000 person-years for developing pancreatic cancer in this group was 1.1 (95% confidence interval, 0.3-3.3). Hence, the rate ratio of pancreatic cancer was almost 9 times higher in patients who developed chronic pancreatitis compared with those who did not (P = 0.049).

CONCLUSIONS

Although a first episode of acute pancreatitis may be related to pancreatic cancer, this risk is mainly present in patients who progress to chronic pancreatitis.

摘要

目的

急性胰腺炎可能是胰腺癌的首发表现。本研究旨在评估首次发作急性胰腺炎后发生胰腺癌的风险。

方法

在2004年3月至2007年3月期间，对所有连续的首次发作急性胰腺炎患者进行前瞻性登记。随访基于医院记录审核、影像学检查和患者问卷调查。结局根据慢性胰腺炎的发生情况进行分层。

结果

我们纳入了731例患者。中位随访时间为55个月。51例患者（7.0%）被诊断为进展为慢性胰腺炎。在该组中，每1000人年发生胰腺癌的发病率为9.0（95%置信区间，2.3 - 35.7）。在未发生慢性胰腺炎的680例患者组中，该组每1000人年发生胰腺癌的发病率为1.1（95%置信区间，0.3 - 3.3）。因此，发生慢性胰腺炎的患者发生胰腺癌的比率比未发生慢性胰腺炎的患者高近9倍（P = 0.049）。