INCIDENCE AND DIAGNOSTIC-SIGNIFICANCE OF MINOR PATHOLOGIC-CHANGES IN THE ADULT PANCREAS AT AUTOPSY - A SYSTEMATIC STUDY OF 112 AUTOPSIES IN PATIENTS WITHOUT KNOWN PANCREATIC DISEASE
INCIDENCE AND DIAGNOSTIC-SIGNIFICANCE OF MINOR PATHOLOGIC-CHANGES IN THE ADULT PANCREAS AT AUTOPSY - A SYSTEMATIC STUDY OF 112 AUTOPSIES IN PATIENTS WITHOUT KNOWN PANCREATIC DISEASE
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DOI：
10.1016/s0046-8177(84)80294-4
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发表时间：
1984-01-01
期刊：
影响因子：
3.3
通讯作者：
STAMM, BH
中科院分区：
文献类型：
--
作者：
STAMM, BH
在112例无已知胰腺疾病（成人发病糖尿病除外）的成人患者的尸检中，检查胰腺以确定胰腺微小病变的发生率和程度，如脂肪增多症、纤维化、导管和导管上皮改变、炎性浸润、局灶性坏死、腺泡扩张和血管变化。然后对每个病变与患者年龄和许多临床状况的统计学显著相关性进行测试，这些临床状况包括胆石症、成人发病糖尿病、肥胖、全身严重动脉粥样硬化、慢性酒精中毒、死亡前严重细菌感染和全身恶性肿瘤。这样做是希望找到胰腺病变的相关或诱发因素。结果显示，除了各种胰腺病变的意外高发病率外，随着年龄的增长，脂肪增多症、纤维化以及导管和导管上皮改变明显增加;这些情况伴随着腺体平均重量的稳定下降，从大约40岁开始，晚期脂肪增多症的情况除外。后一种情况与成人型糖尿病有关。严重的全身性动脉粥样硬化与脂肪增多症和纤维化有关，但后两种情况很少同时出现。急性（终末）病变，包括局灶性坏死和腺泡扩张，与死亡前的严重细菌性疾病相关。其他具有统计学意义的相关性很少见，表明这些胰腺微小病变缺乏特异性，而不是提供其发病机制的线索。本文对这些病变的诊断意义及其与临床相关的慢性胰腺炎的关系作了简要讨论。
In 112 unselected autopsies of adult patients without known pancreatic disease (except adult-onset diabetes mellitus), the pancreas was examined to establish the incidence and degree of such minor pancreatic lesions as lipomatosis, fibrosis, alterations of ducts and ductal epithelium, inflammatory infiltrates, focal necrosis, acinar dilation, and vascular changes. Each lesion was then tested for statistically significant correlations with the age of the patient and a number of clinical conditions, including cholelithiasis, adult-onset diabetes mellitus, adiposity, generalized severe atherosclerosis, chronic alcoholism, severe bacterial infection prior to death, and generalized malignant tumor. This was done in the hope of finding associated or predisposing factors for the pancreatic lesions. The results show, in addition to the unexpectedly high incidence of the various pancreatic lesions, a clear increase of lipomatosis, fibrosis, and both ductal and ductal epithelial alterations with increasing age; these conditions were accompanied by a steady decrease in the mean weight of the gland, starting at the age of about 40 yr, except in cases of advanced lipomatosis. The latter condition was associated with adult-onset diabetes mellitus. Severe generalized atherosclerosis was correlated with lipomatosis and fibrosis, but the 2 latter conditions were found together only rarely. Acute (terminal) lesions, including focal necrosis and acinar dilation, were associated with severe bacterial disease prior to death. Other statistically significant correlations were rare, indicating the lack of specificity of these minor pancreatic lesions rather than offering a clue as to their pathogenesis. The diagnostic significance and the relations of these lesions to clinically relevant chronic pancreatitis are discussed briefly.