From the Department of Internal Medicine, Division of Gastroenterology and Hepatology.
Saint Louis University Center for Outcomes Research, Saint Louis University School of Medicine, St Louis, MO.
Pancreas. 2019 Sep;48(8):1092-1097. doi: 10.1097/MPA.0000000000001372.
This study aimed to determine the distribution of etiology of pancreatic cysts using established criteria/markers from cyst fluid analysis and cytology that have been reported to have high specificity in published literature.
A retrospective study of pancreatic cysts using an endoscopic database from March 2002 and May 2013 was conducted. Pancreatic cysts <10 mm and cysts with a history of pancreatic cancer were excluded.
In our cohort of 758 patients with pancreatic cyst(s), the cyst etiology was as follows: mucinous cyst/side-branch intraductal papillary mucinous neoplasms (SB-IPMNs)/mucinous cystic neoplasms (MCN; 48.2%), pseudocyst (27.6%), serous cystadenoma (11%), simple cysts (6.4%), mucinous cystadenocarcinoma (5.1%), and other (1%). Approximately 41% (n = 310) of the cysts were ≥3 cm in size and included the following: pseudocyst (39.7%), mucinous cysts/SB-IPMN/MCN (28.1%), serous cystadenoma (16.7%), mucinous cyst adenocarcinoma (9.7%), and simple cyst (4.8%). In 118 patients with a known history of acute pancreatitis, the cyst diagnoses included pseudocyst (68.7%), mucinous cyst/SB-IPMN/MCN (18.6%), benign/simple cyst (7.6%), and mucinous cystadenocarcinoma (2.5%).
In patients with cystic pancreatic lesion noted on cross-sectional imaging, approximately half of the patients have lesions without malignancy or malignant potential and therefore not requiring surveillance. Endoscopic ultrasound/endoscopic ultrasound-guided fine-needle aspiration evaluation of the pancreatic cysts can help optimize their further management.
本研究旨在使用已发表文献中报道具有高特异性的囊液分析和细胞学标准/标志物来确定胰腺囊肿的病因分布。
对 2002 年 3 月至 2013 年 5 月的内镜数据库进行胰腺囊肿的回顾性研究。排除 <10mm 的胰腺囊肿和有胰腺癌病史的囊肿。
在我们的 758 例胰腺囊肿患者队列中，囊肿病因如下：黏液性囊/分支胰管内乳头状黏液性肿瘤（SB-IPMN）/黏液性囊腺瘤（MCN；48.2%）、假性囊肿（27.6%）、浆液性囊腺瘤（11%）、单纯性囊肿（6.4%）、黏液性囊腺癌（5.1%）和其他（1%）。大约 41%（n=310）的囊肿≥3cm，包括以下内容：假性囊肿（39.7%）、黏液性囊肿/SB-IPMN/MCN（28.1%）、浆液性囊腺瘤（16.7%）、黏液性囊腺癌（9.7%）和单纯性囊肿（4.8%）。在 118 例有已知急性胰腺炎病史的患者中，囊肿诊断包括假性囊肿（68.7%）、黏液性囊肿/SB-IPMN/MCN（18.6%）、良性/单纯性囊肿（7.6%）和黏液性囊腺癌（2.5%）。
在影像学检查发现胰腺囊性病变的患者中，大约一半的患者的病变无恶性或恶性潜能，因此不需要监测。对胰腺囊肿进行内镜超声/内镜超声引导下细针抽吸评估有助于优化其进一步管理。
