Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany.
Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany.
Gut. 2018 Jan;67(1):138-145. doi: 10.1136/gutjnl-2016-313127. Epub 2017 Sep 6.
To analyse the prevalence, incidence and clinical relevance of pancreatic cysts detected as incidental finding in a population-based longitudinal study.
A total of 1077 participants (521 men, mean age 55.8±12.8 years) of 2333 participants from the population-based Study of Health in Pomerania (SHIP) underwent magnetic resonance cholangiopancreaticography (MRCP) at baseline (2008-2012). MRCP was analysed for pancreatic cysts with a diameter ≥2 mm. 676/1077 subjects received a 5-year follow-up (2014-2016). The prevalence and incidence of pancreatic cysts (weighted for study participation) were assessed in association to age, gender and suspected epidemiological risk factors. Mortality follow-up was performed in 2015 for all SHIP participants (mean follow-up period 5.9 years, range 3.2-7.5 years).
At baseline pancreatic cysts had a weighted prevalence of 49.1%, with an average number of 3.9 (95% CI 3.2 to 4.5) cysts per subject in the subgroup harbouring cysts. Cyst size ranged from 2 to 29 mm. Prevalence (p<0.001), number (p=0.001) and maximum size (p<0.001) increased significantly with age. The 5-year follow-up revealed a weighted incidence of 12.9% newly detected pancreatic cysts. 57.1% of the subjects initially harbouring pancreatic cysts showed an increase in number and/or maximum cyst size. Of all subjects undergoing MRCP, no participant died of pancreatic diseases within mortality follow-up.
The prevalence of pancreatic cysts in the general population is unexpectedly high, and their number and size increase with age. Overall, no pancreatic cancer was observed in this collective during a 5-year follow-up. Nevertheless, prospective follow-up imaging showed minimal progress in more than 50%. Only about 6% of cysts and 2.5% of the study group initially presented with cysts of more than 1 cm and thus might be clinically meaningful.
分析在一项基于人群的纵向研究中偶然发现的胰腺囊肿的患病率、发病率和临床相关性。
共有 2333 名参与基于人群的什未林健康研究（SHIP）的参与者中的 1077 名（521 名男性，平均年龄 55.8±12.8 岁）在基线（2008-2012 年）时接受了磁共振胰胆管成像（MRCP）检查。MRCP 分析了直径≥2mm 的胰腺囊肿。1077 名受试者中有 676 名（676/1077）接受了 5 年随访（2014-2016 年）。评估了胰腺囊肿（按研究参与加权）的患病率和发病率与年龄、性别和可疑的流行病学危险因素的关系。2015 年对所有 SHIP 参与者进行了死亡率随访（平均随访期 5.9 年，范围 3.2-7.5 年）。
基线时胰腺囊肿的加权患病率为 49.1%，在存在囊肿的亚组中，每个受试者的平均囊肿数为 3.9（95%CI 3.2-4.5）个。囊肿大小从 2 到 29mm 不等。患病率（p<0.001）、数量（p=0.001）和最大尺寸（p<0.001）随年龄显著增加。5 年随访发现新诊断的胰腺囊肿加权发病率为 12.9%。最初存在胰腺囊肿的受试者中，57.1%的受试者囊肿数量和/或最大囊肿尺寸增加。在接受 MRCP 的所有受试者中，在随访期间没有死于胰腺疾病的患者。
在一般人群中，胰腺囊肿的患病率出乎意料地高，且其数量和大小随年龄增长而增加。总的来说，在 5 年的随访中，这个群体中没有观察到胰腺癌。然而，前瞻性随访成像显示，超过 50%的患者有微小进展。只有约 6%的囊肿和 2.5%的研究组最初存在超过 1cm 的囊肿，因此可能具有临床意义。
