Phillips Anna Evans, Shah Nilesh, Borhani Amir A, Yadav Dhiraj, Brand Randall E
Dental Public Health, School of Dental Medicine.
Pancreas. 2018 Nov-Dec;47(10):1262-1266. doi: 10.1097/MPA.0000000000001160.
Presentation of pancreatic adenocarcinoma (PC) as acute pancreatitis (AP), association of chronic pancreatitis (CP) with PC, and role of inflammation in PC carcinogenesis are well recognized. We hypothesized that inflammatory changes associated with remote history of AP (≥2 years before PC diagnosis) would result in earlier age of PC diagnosis.
We evaluated PC patients prospectively enrolled in the Pancreatic Adenocarcinoma Gene Environment Risk (PAGER) study at the University of Pittsburgh for history of pancreatitis and reviewed relevant medical records and imaging studies. Univariate and multivariable linear regression analyses evaluated the relationship between PC and remote history of AP.
Among 790 patients with histologically confirmed PC, 114 (14.4%) had a history of pancreatitis (AP within 2 years of PC diagnosis in 69 [8.7%], remote history of AP in 28 [3.5%], CP in 4 [0.5%], and unknown duration of pancreatitis in 13 [1.6%]). After controlling for age, sex, body mass index, smoking, alcohol history, and diabetic status at diagnosis, patients with a remote history of AP were diagnosed on average 4.7 years earlier with PC when compared with PC patients without history of AP (P < 0.035).
Remote history of AP may accelerate carcinogenesis in PC.
胰腺癌（PC）表现为急性胰腺炎（AP）、慢性胰腺炎（CP）与PC的关联以及炎症在PC致癌过程中的作用已得到充分认识。我们假设与AP远期病史（PC诊断前≥2年）相关的炎症变化会导致PC诊断年龄提前。
我们对前瞻性纳入匹兹堡大学胰腺癌基因环境风险（PAGER）研究的PC患者进行胰腺炎病史评估，并查阅相关病历和影像学研究。单因素和多因素线性回归分析评估PC与AP远期病史之间的关系。
在790例经组织学确诊的PC患者中，114例（14.4%）有胰腺炎病史（69例[8.7%]在PC诊断后2年内发生AP，28例[3.5%]有AP远期病史，4例[0.5%]有CP，13例[1.6%]胰腺炎病程不明）。在控制年龄、性别、体重指数、吸烟、饮酒史和诊断时的糖尿病状态后，与无AP病史的PC患者相比，有AP远期病史的患者PC诊断平均提前4.7年（P < 0.035）。
AP远期病史可能加速PC的致癌过程。
