From the Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai.
Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou.
Pancreas. 2020 Aug;49(7):967-974. doi: 10.1097/MPA.0000000000001610.
The study concerns identifying risk factors and developing nomogram for pancreatic pseudocyst (PPC) in idiopathic chronic pancreatitis (ICP) to facilitate early diagnosis.
From January 2000 to December 2013, ICP patients admitted to our center were enrolled. Cumulative incidence of PPC was determined by Kaplan-Meier method. Patients were randomized into training group and validation group in a 2:1 ratio. Risk factors of PPC were determined through Cox proportional hazards regression model based on training cohort. The nomogram was constructed according to risk factors.
Totally, 1633 ICP patients were included with a median follow-up duration of 9.8 years. Pancreatic pseudocyst was observed in 14.7% (240/1633) of patients after ICP onset. The cumulative incidences of PPC were 8.2%, 10.4%, and 12.9% at 3, 5, and 10 years after ICP onset, respectively. Male sex, smoking history, history of severe acute pancreatitis, and chronic pain at/before diagnosis of ICP and complex pathologic changes in main pancreatic duct were recognized as risk factors of PPC development. The nomogram constructed with these risk factors achieved good concordance indexes.
Risk for PPC could be estimated through the nomogram. High-risk patients were suggested to be followed up closely to help early diagnosis of PPC.
本研究旨在确定特发性慢性胰腺炎（ICP）中胰腺假性囊肿（PPC）的风险因素并建立列线图，以方便早期诊断。
从 2000 年 1 月至 2013 年 12 月，纳入我院收治的 ICP 患者。采用 Kaplan-Meier 法确定 PPC 的累积发生率。将患者按 2:1 的比例随机分为训练组和验证组。基于训练队列，通过 Cox 比例风险回归模型确定 PPC 的风险因素。根据风险因素构建列线图。
共纳入 1633 例 ICP 患者，中位随访时间为 9.8 年。在 ICP 发病后，有 14.7%（240/1633）的患者发生胰腺假性囊肿。PPC 的累积发生率分别为 ICP 发病后 3、5 和 10 年时的 8.2%、10.4%和 12.9%。男性、吸烟史、重症急性胰腺炎史、ICP 诊断前/时的慢性疼痛和主胰管的复杂病理改变被认为是 PPC 发展的危险因素。使用这些风险因素构建的列线图具有良好的一致性指数。
可以通过列线图来估计 PPC 的风险。建议对高危患者进行密切随访，以帮助早期诊断 PPC。
