原发性硬化性胆管炎(PSC)与肝胆和结直肠癌有关,但PSC是否会增加胰腺癌的风险仍不确定.虽然一些欧洲研究表明PSC患者患胰腺癌的风险增加,其他研究没有。这些研究并没有很好地解释伴随的炎症性肠病(IBD)的存在或不存在。这项研究的目的是调查患有和不患有IBD的PSC的美国退伍军人中胰腺癌的患病率。
■这项回顾性研究使用了国际疾病分类,用于识别PSC患者的第十次修订(ICD-10)代码,IBD,和胰腺癌来自退伍军人事务部(VA)企业数据仓库。胰腺癌的患病率仅在PSC患者中,仅限IBD,带IBD的PSC,PSC和IBD均未进行比较。Logistic回归用于控制年龄,性别,慢性胰腺炎,糖尿病,烟草和酒精的使用。
■从超过900万退伍军人中确定了946名PSC患者。其中486例(51.4%)并发IBD。此外,还确定了112,653例无PSC的IBD患者。当针对混杂因素进行调整时,与普通人群和无PSC的IBD患者相比,PSC患者的胰腺癌患病率明显更高(2.4%vs.0.2%和0.5%,分别)。
■PSC退伍军人,特别是那些没有合并IBD的人,与普通退伍军人相比,胰腺癌的患病率很高。我们的研究结果支持多中心前瞻性研究的必要性,以调查筛查胰腺癌对PSC患者的益处。
Primary sclerosing cholangitis (PSC) is associated with hepatobiliary and colorectal cancers, but it remains uncertain if PSC increases the risk for pancreatic cancer. While some European studies have suggested an increased risk of pancreatic cancer in PSC patients, other studies have not. And these studies did not well account for presence or absence of concomitant inflammatory bowel disease (IBD). The purpose of this
study is to investigate the prevalence of pancreatic cancer in United States veterans with PSC both with and without IBD.
UNASSIGNED: This retrospective
study used International Classification of Diseases, Tenth Revision (ICD-10) codes to identify patients with PSC, IBD, and pancreatic cancer from the Veterans Affairs (VA) Corporate Data Warehouse. The prevalence of pancreatic cancer in patients with PSC only, IBD only, PSC with IBD, and neither PSC nor IBD were compared. Logistic regression was used to control for age, gender, chronic pancreatitis, diabetes mellitus, and tobacco and alcohol use.
UNASSIGNED: A total of 946 patients with PSC were identified from a population of over 9 million veterans. 486 (51.4%) of these had concurrent IBD. Additionally 112,653 patients with IBD without PSC were identified. When adjusted for confounding factors, patients with PSC had a significantly higher prevalence of pancreatic cancer compared to the general population and those with IBD without PSC (2.4% vs. 0.2% and 0.5%, respectively).
UNASSIGNED: Veterans with PSC, particularly those without concomitant IBD, have a high prevalence of pancreatic cancer compared to the general veteran population. Our findings support the need for multicenter prospective studies investigating the benefits of screening for pancreatic cancer in patients with PSC.