Nakhaei Masoud, Bligh Mathew, Chernyak Victoria, Bezuidenhout Abraham F, Brook Alexander, Brook Olga R
Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA.
Department of Radiology, Montefiore, Bronx, NY, USA.
Eur Radiol. 2022 May;32(5):3369-3376. doi: 10.1007/s00330-021-08428-1. Epub 2022 Jan 11.
To assess the long-term malignancy risk of incidental small pancreatic cysts.
In this HIPAA-compliant, IRB-approved, retrospective, multi-institutional study, the long-term incidence of pancreatic cancer was compared between patients with and without small pancreatic cysts. Patients with incidental pancreatic cysts ≥ 0.5 and < 2.0 cm in maximal diameter, detected on MRI performed between 1999 and 2011, represented the "small pancreatic cyst" group. Patients that underwent MRI between 2005 and 2011 and had no reported pancreatic cysts represented the comparison "no cyst" group.
The "small pancreatic cyst" group included 267 patients, ages 63.4 ± 11.8 years, 166/267 (62%) women with a mean follow-up of 8.6 ± 4.3 years, median 9.2 years; the "no cyst" group included 1,459 patients, ages 64.6 ± 12 years, 794/1,459 (54%) women with a mean follow-up of 7.0 ± 4.2 years, median 7.8 (p values 0.12, 0.02, < 0.001, respectively). Two/267 (0.7%) patients developed pancreatic cancer at a separate location from the known cyst in the "small pancreatic cyst" group, with a cancer rate of 0.9 (95% CI 0.1-3.1) cases per 1,000 patient-years. In the "no cyst" cohort, 18/1,459 (1.2%) patients developed pancreatic cancer, with a cancer rate of 1.8 (95% CI 1.2-3.1) cases per 1,000 patient-years (p = 0.6). The all-cause mortality was similar in both groups: 57/267 (21%) vs. 384/1,459 (26%) (p = 0.09).
The long-term risk of pancreatic malignancy in asymptomatic patients with incidental pancreatic cysts less than 2 cm is 0.9 cases per 1,000 patient-years of follow-up, similar to those without pancreatic cysts. These very few pancreatic cancers developed at a separate location from the known cyst.
• After a median of 9.2 years of follow-up, the risk of pancreatic malignancy in patients with an asymptomatic small pancreatic cyst was 0.9 cases per 1,000 patient-years of follow-up, similar to those without pancreatic cysts. • Very few pancreatic cancer cases developed in the location separate from the known pancreatic cyst.
评估偶然发现的小胰腺囊肿的长期恶性风险。
在这项符合HIPAA规定、经机构审查委员会批准的多机构回顾性研究中，比较了有和没有小胰腺囊肿患者的胰腺癌长期发病率。1999年至2011年间进行的MRI检查发现的最大直径≥0.5 cm且<2.0 cm的偶然胰腺囊肿患者组成“小胰腺囊肿”组。2005年至2011年间接受MRI检查且未报告有胰腺囊肿的患者组成对照“无囊肿”组。
“小胰腺囊肿”组包括267例患者，年龄63.4±11.8岁，166/267（62%）为女性，平均随访8.6±4.3年，中位数9.2年；“无囊肿”组包括1459例患者，年龄64.6±12岁，794/1459（54%）为女性，平均随访7.0±4.2年，中位数7.8年（p值分别为0.12、0.02、<0.001）。“小胰腺囊肿”组中有2/267（0.7%）患者在已知囊肿以外的部位发生了胰腺癌，癌症发生率为每1000患者年0.9例（95%CI 0.1 - 3.1）。在“无囊肿”队列中，18/1459（1.2%）患者发生了胰腺癌，癌症发生率为每1000患者年1.8例（95%CI 1.2 - 3.1）（p = 0.6）。两组的全因死亡率相似：57/267（21%）对384/1459（26%）（p = 0.09）。
偶然发现的小于2 cm胰腺囊肿的无症状患者的胰腺癌长期风险为每1000患者年随访0.9例，与无胰腺囊肿的患者相似。这些胰腺癌极少发生在已知囊肿以外的部位。
• 经过中位数9.2年的随访，无症状小胰腺囊肿患者的胰腺癌风险为每1000患者年随访0.9例，与无胰腺囊肿的患者相似。• 在已知胰腺囊肿以外的部位发生的胰腺癌病例极少。
