Division of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, South Korea.
Division of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, South Korea.
Pancreatology. 2023 Aug;23(5):449-455. doi: 10.1016/j.pan.2023.05.001. Epub 2023 May 5.
We investigated the short- and long-term risks of pancreatic cancer after the diagnosis of acute pancreatitis.
This population-based matched-cohort study used data from the Korean National Health Insurance Service database. Patients with acute pancreatitis (n = 25,488) were matched with the control group (n = 127,440) based on age, sex, body mass index, smoking status, and diabetes. We estimated the hazard ratios for developing pancreatic cancer in both groups using Cox regression analysis.
During a median follow-up of 5.4 years, pancreatic cancer developed in 479 patients (1.9%) in the acute pancreatitis group and 317 patients (0.2%) in the control group. Compared with the control group, the risk of pancreatic cancer in the acute pancreatitis group was very high within the first 2 years, which gradually decreased over time. The hazard ratio for the risk of developing pancreatitis was 8.46 (95% confidence interval, 5.57-12.84) at 1-2 years, and then decreased to 3.62 (95% confidence interval, 2.26-4.91) at 2-4 years. However, even after 8-10 years, the hazard ratio was still statistically significantly increased to 2.80 (95% confidence interval, 1.42-5.53). After 10 years, there was no significant difference in the risk of pancreatic cancer between the two groups.
The risk of pancreatic cancer increases rapidly after acute pancreatitis diagnosis, gradually declines after 2 years, and remains elevated for up to 10 years. Further studies are needed to determine the long-term effects of acute pancreatitis on the risk of pancreatic cancer.
本研究旨在探讨急性胰腺炎确诊后罹患胰腺癌的短期和长期风险。
本基于人群的匹配队列研究使用了韩国国家健康保险服务数据库的数据。根据年龄、性别、体重指数、吸烟状况和糖尿病，将急性胰腺炎患者（n=25488）与对照组（n=127440）进行匹配。采用 Cox 回归分析估计两组发生胰腺癌的风险比。
在中位随访 5.4 年期间，急性胰腺炎组中有 479 例（1.9%）患者和对照组中有 317 例（0.2%）患者发生了胰腺癌。与对照组相比，急性胰腺炎组在确诊后 2 年内罹患胰腺癌的风险非常高，随着时间的推移逐渐降低。急性胰腺炎组在 1-2 年内发生胰腺癌的风险比为 8.46（95%置信区间，5.57-12.84），在 2-4 年内降至 3.62（95%置信区间，2.26-4.91）。然而，即使在 8-10 年后，风险比仍具有统计学意义，为 2.80（95%置信区间，1.42-5.53）。在 10 年后，两组之间发生胰腺癌的风险无显著差异。
急性胰腺炎确诊后，胰腺癌的风险迅速增加，2 年后逐渐下降，持续长达 10 年。需要进一步研究来确定急性胰腺炎对胰腺癌风险的长期影响。
