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Association between chronic pancreatitis and pancreatic cancer: A 10-year retrospective study of endoscopically treated and surgical patients.
International Journal of Cancer ( IF 5.7 ) Pub Date : 2020-03-12 , DOI: 10.1002/ijc.32971
Taija Korpela 1 , Marianne Udd 1 , Harri Mustonen 1, 2 , Ari Ristimäki 3 , Caj Haglund 1, 2 , Hanna Seppänen 1, 2 , Leena Kylänpää 1
Affiliation  

Pancreatic cancer (PC) has a poor prognosis. Chronic pancreatitis (CP) associates with high morbidity and mortality, and serves as a risk factor for PC. Our study aimed to assess the association between endoscopically treated CP patients and PC, and to establish the rate of CP among patients undergoing surgery for pancreatic ductal adenocarcinoma (PDAC). We retrospectively analyzed 458 CP patients undergoing endoscopic treatment (ET) between 2000 and 2010 and 349 PDAC patients undergoing pancreatic resection between 2000 and 2014 at the Helsinki University Hospital. The likelihood of diagnosing PC was highest within 2 years of a CP diagnosis: 21 of 30 PC diagnoses occurred during this time. After 2 years follow‐up: 9 of 30 PC diagnoses occurred 2–12 years from CP diagnosis. Two patients were diagnosed with CP before PDAC. Multivariate analysis showed two prognostic factors indicative of PC development: biliary stricture (HR 9.21; 95% CI 3.76–22.08) and a higher age (per 5‐year increases) at CP onset (HR 1.55; 95% CI 1.30–1.85). Among 458 CP patients, the median overall survival without PC was 14.7 years (95% CI 12.0–17.3), falling to 1.6 years (95% CI 1.2–2.0) with PC. The high incidence of PC among CP patients at the beginning of follow‐up likely reflected an initially missed PC diagnoses. In long‐term follow‐up, an increasing PC incidence might reflect the PC‐predisposing impact of CP. Thus, we recommend careful follow‐up for patients presenting with a recently diagnosed CP and risk factors for PC.

中文翻译:

慢性胰腺炎和胰腺癌之间的关联:对经内镜治疗和手术的患者进行的十年回顾性研究。

胰腺癌(PC)的预后较差。慢性胰腺炎(CP)与高发病率和高死亡率相关,并且是PC的危险因素。我们的研究旨在评估经内镜治疗的CP患者与PC之间的关联,并确定接受胰管腺癌(PDAC)手术的患者中的CP率。我们回顾性分析了赫尔辛基大学医院在2000年至2010年期间接受内镜治疗(ET)的458名CP患者以及在2000年至2014年之间进行了胰腺切除术的349名PDAC患者。CP诊断后2年内,诊断PC的可能性最高:在这段时间内进行了30例PC诊断中的21例。经过2年的随访:30次PC诊断中有9次发生在CP诊断后2–12年。两名患者在PDAC之前被诊断为CP。多变量分析显示了两个预后因素,提示PC发展:胆道狭窄(HR 9.21; 95%CI 3.76-22.08)和CP发作时年龄较高(每5年增加)(HR 1.55; 95%CI 1.30-1.85)。在458名CP患者中,无PC的中位总体生存期为14.7年(95%CI 12.0-17.3),有PC的患者降至1.6年(95%CI 1.2-2.0)。在随访开始时,CP患者中PC的高发病率可能反映了最初错过的PC诊断。在长期随访中,PC发生率的增加可能反映了CP对PC的易感影响。因此,我们建议对最近诊断为CP和PC危险因素的患者进行仔细随访。95%CI 1.30-1.85)。在458名CP患者中,无PC的中位总生存期为14.7年(95%CI 12.0-17.3),有PC的患者降至1.6年(95%CI 1.2-2.0)。在随访开始时,CP患者中PC的高发病率可能反映了最初错过的PC诊断。在长期随访中,PC发生率的增加可能反映了CP对PC的易感影响。因此,我们建议对最近诊断为CP和PC危险因素的患者进行仔细随访。95%CI 1.30-1.85)。在458名CP患者中,无PC的中位总体生存期为14.7年(95%CI 12.0-17.3),有PC的患者降至1.6年(95%CI 1.2-2.0)。在随访开始时,CP患者中PC的高发病率可能反映了最初错过的PC诊断。在长期随访中,PC发生率的增加可能反映了CP对PC的易感影响。因此,我们建议对最近诊断为CP和PC危险因素的患者进行仔细随访。PC发生率的增加可能反映了CP的PC易感性影响。因此,我们建议对最近诊断为CP和PC危险因素的患者进行仔细随访。PC发生率的增加可能反映了CP的PC易感性影响。因此,我们建议对最近诊断为CP和PC危险因素的患者进行仔细随访。
更新日期:2020-03-12
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