Buerlein Ross C D, Shami Vanessa M
University of Virginia Digestive Health, Charlottesville, VA, USA.
University of Virginia Digestive Health, 1215 Lee Street, Charlottesville, VA 22903, USA.
Ther Adv Gastrointest Endosc. 2021 Sep 23;14:26317745211045769. doi: 10.1177/26317745211045769. eCollection 2021 Jan-Dec.
The prevalence of pancreatic cysts has increased significantly over the last decade, partly secondary to increased quality and frequency of cross-sectional imaging. While the majority never progress to cancer, a small number will and need to be followed. The management of pancreatic cysts can be both confusing and intimidating due to the multiple guidelines with varying recommendations. Despite the differences in the specifics of the guidelines, they all agree on several high-risk features that should get the attention of any clinician when assessing a pancreatic cyst: presence of a mural nodule or solid component, dilation of the main pancreatic duct (or presence of main duct intraductal papillary mucinous neoplasm), pancreatic cyst size ⩾3-4 cm, or positive cytology on pancreatic cyst fluid aspiration. Other important criteria to consider include rapid cyst growth (⩾5 mm/year), elevated serum carbohydrate antigen 19-9 levels, new-onset diabetes mellitus, or acute pancreatitis thought to be related to the cystic lesion.
在过去十年中，胰腺囊肿的患病率显著上升，部分原因是横断面成像的质量和频率提高。虽然大多数囊肿不会发展为癌症，但少数会发展，需要进行随访。由于多种指南的建议各不相同，胰腺囊肿的管理可能既令人困惑又令人生畏。尽管指南的具体内容存在差异，但它们都认同几个高风险特征，在评估胰腺囊肿时，任何临床医生都应关注这些特征：存在壁结节或实性成分、主胰管扩张（或存在主胰管内乳头状黏液性肿瘤）、胰腺囊肿大小≥3 - 4厘米，或胰腺囊肿液抽吸细胞学检查呈阳性。其他需要考虑的重要标准包括囊肿快速生长（≥5毫米/年）、血清糖类抗原19 - 9水平升高、新发糖尿病或被认为与囊性病变相关的急性胰腺炎。
