Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, Virginia.
Division of Hematology and Oncology, University of Michigan, Ann Arbor, Michigan.
Clin Gastroenterol Hepatol. 2024 Sep;22(9):1798-1809.e6. doi: 10.1016/j.cgh.2024.02.018. Epub 2024 Feb 28.
BACKGROUND & AIMS: Understanding the burden of pancreatic cystic lesions (PCLs) in the general population is important for clinicians and policymakers. In this systematic review, we sought to estimate the global prevalence of PCLs using magnetic resonance imaging (MRI) and to investigate factors that contribute to its variation.
We searched MEDLINE, EMBASE, and Cochrane Central, from database inception through February 2023. We included full-text articles that reported the prevalence of PCLs using MRI in the general population. A proportional meta-analysis was performed, and the prevalence of PCLs was pooled using a random-effects model.
Fifteen studies with 65,607 subjects were identified. The pooled prevalence of PCLs was 16% (95% confidence interval [CI], 13%-18%; I = 99%), most of which were under 10 mm. Age-specific prevalence of PCLs increased from 9% (95% CI, 7%-12%) at 50 to 59 years, to 18% (95% CI, 14%-22%) at 60 to 69 years, 26% (95% CI, 20%-33%) at 70 to 79 years, and 38% at 80 years and above (95% CI, 25%-52%). There was no difference in prevalence between sexes. Subgroup analysis showed higher PCL prevalence when imaging findings were confirmed by independent radiologist(s) (25%; 95% CI, 16%-33%) than when chart review alone was used (5%; 95% CI, 4%-7%; P < .01). There was no independent association of PCL prevalence with geographic location (Europe, North America, or Asia), MRI indication (screening vs evaluation of non-pancreatic pathology), enrollment period, sample size, magnet strength (1.5 vs 3 tesla), and MRI sequence (magnetic resonance cholangiopancreatography vs no magnetic resonance cholangiopancreatography).
In this systematic review, the global prevalence of PCLs using a highly sensitive noninvasive imaging modality ranged between 13% and 18%.
了解普通人群中胰腺囊性病变（PCL）的负担对于临床医生和政策制定者至关重要。在本系统评价中，我们试图使用磁共振成像（MRI）估计 PCL 的全球患病率，并探讨导致其变化的因素。
我们检索了 MEDLINE、EMBASE 和 Cochrane Central，检索时间从数据库建立到 2023 年 2 月。我们纳入了使用 MRI 报告普通人群中 PCL 患病率的全文文章。使用比例荟萃分析，使用随机效应模型汇总 PCL 的患病率。
确定了 15 项研究，涉及 65607 名受试者。PCL 的总体患病率为 16%（95%置信区间[CI]，13%-18%；I=99%），其中大多数病变小于 10mm。特定年龄的 PCL 患病率从 50-59 岁的 9%（95%CI，7%-12%）增加到 60-69 岁的 18%（95%CI，14%-22%）、70-79 岁的 26%（95%CI，20%-33%）和 80 岁及以上的 38%（95%CI，25%-52%）。男女之间的患病率没有差异。亚组分析显示，当影像学发现由独立放射科医生（25%；95%CI，16%-33%）证实时，PCL 的患病率较高，而仅使用图表审查（5%；95%CI，4%-7%；P<.01）时则较低。PCL 患病率与地理位置（欧洲、北美或亚洲）、MRI 指征（筛查与非胰腺病理评估）、入组时间、样本量、磁场强度（1.5 与 3 特斯拉）和 MRI 序列（磁共振胰胆管成像与无磁共振胰胆管成像）无关。
在本系统评价中，使用高敏感的非侵入性成像方式，PCL 的全球患病率在 13%至 18%之间。
