脂肪胰诊断及其临床意义的研究进展
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摘要
近年来研究发现脂肪胰(fatty pancreas,FP)主要表现为胰腺实质细胞内外的脂肪积聚。目前临床上对其主要有超声、计算机断层扫描(computed tomography,CT)、磁共振(magnetic resonance,MR)等多种诊断方法。临床研究还发现其与糖尿病、胰腺肿瘤等多种疾病相关。该文主要对其临床诊断及临床意义作一综述。
Fatty pancreas( FP) is proposed and studied in recent years,whose main manifestations are that fat accumulates inside and outside the cells of pancreatic parenchyma. Currently,it is clinically diagnosed by ultrasound,computed tomography( CT),magnetic resonance( MR) and other methods and has been found to be associated with diabetes,pancreatic cancer and other diseases in clinical studies. In this paper,we review the researches of its clinical diagnosis and clinical implications.
Fatty pancreas( FP) is proposed and studied in recent years,whose main manifestations are that fat accumulates inside and outside the cells of pancreatic parenchyma. Currently,it is clinically diagnosed by ultrasound,computed tomography( CT),magnetic resonance( MR) and other methods and has been found to be associated with diabetes,pancreatic cancer and other diseases in clinical studies. In this paper,we review the researches of its clinical diagnosis and clinical implications.
引文
1 Schaefer JH. The normal weight of the pancreas in the adult human being-A biometric study[J]. Anat Rec(Hoboken),1926,32(2):119-132.
2 Ogilvie RF. The islands of langerhans in 19 cases of obesity[J]. J Pathol Bacteriol,1933,37(3):473-481.
3 Olsen TS. Lipomatosis of the pancreas in autopsy material and its relation to age and overweight[J]. Acta Pathol Microbiol Scand A,1978,86A(5):367-373.
4 Smits MM,van Geenen EJ. The clinical significance of pancreatic steatosis[J]. Nat Rev Gastroenterol Hepatol,2011,8(3):169-177.
5 Matsumoto S,Mori H,Miyake H,et al. Uneven fatty replacement of the pancreas:evaluation with CT[J]. Radiology,1995,194(2):453-458.
6 Sepe PS,Ohri A,Sanaka S,et al. A prospective evaluation of fatty pancreas by using EUS[J]. Gastrointest Endosc,2011,73(5):987-993.
7 Kim SY,Kim H,Cho JY,et al. Quantitative assessment of pancreatic fat by using unenhanced CT:pathologic correlation and clinical implications[J]. Radiology,2014,271(1):104-112.
8 Tranchart H,Gaujoux S,Rebours V,et al. Preoperative CT scan helps to predict the occurrence of severe pancreatic fistula after pancreaticoduodenectomy[J]. Ann Surg,2012,256(1):139-145.
9 Schwenzer NF,Machann J,Martirosian P,et al. Quantification of pancreatic lipomatosis and liver steatosis by MRI:comparison of in/opposed-phase and spectral-spatial excitation techniques[J]. Invest Radiol,2008,43(5):330-337.
10 Lingvay I,Esser V,Legendre JL,et al. Noninvasive quantification of pancreatic fat in humans[J]. J Clin Endocrinol Metab,2009,94(10):4070-4076.
11 Idilman IS,Tuzun A,Savas B,et al. Quantification of liver,pancreas,kidney,and vertebral body MRI-PDFF in non-alcoholic fatty liver disease[J]. Abdom Imaging,2015,40(6):1512-1519.
12 Hu HH,Smith DL Jr,Nayak KS,et al. Identification of brown adipose tissue in mice with fat-water IDEAL-MRI[J]. J Magn Reson Imaging,2010,31(5):1195-1202.
13 Zhao ZZ,Xin LL,Xia JH,et al. Long-term High-fat High-sucrose Diet Promotes Enlarged Islets andβ-Cell Damage by Oxidative Stress in Bama Minipigs[J]. Pancreas,2015,44(6):888-895.
14 Heni M,Machann J,Staiger H,et al. Pancreatic fat is negatively associated with insulin secretion in individuals with impaired fasting glucose and/or impaired glucose tolerance:a nuclear magnetic resonance study[J]. Diabetes Metab Res Rev. 2010,26(3):200-205.
15 Tushuizen ME,Bunck MC,Pouwels PJ,et al. Pancreatic fat content and beta-cell function in men with and without type 2 diabetes[J]. Diabetes Care,2007,30(11):2916-2921.
16 Jeong JS,Kim MK,Han KD,et al. The Association between Pancreatic Steatosis and Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients[J]. Diabetes Metab J,2018,42(5):425-432.
17 Chen DL,Liess C,Poljak A,et al. Phenotypic Characterization of Insulin-Resistant and Insulin-Sensitive Obesity[J]. J Clin Endocrinol Metab,2015,100(11):4082-4091.
18 Di Magno EP,Go VL,Summerskill WH. Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency[J]. N Engl J Med,1973,288(16):813-815.
19 Hellara O,Saad J,Ben Chaabene N,et al. Diffuse primary fat replacement of the pancreas:an unusual cause of steatorrhea[J]. Tunis Med,2013,91(5):359-360.
20 Mathur A,Marine M,Lu D,et al. Nonalcoholic fatty pancreas disease[J]. HPB(Oxford),2007,9(4):312-318.
21 Acharya C,Cline RA,Jaligama D,et al. Fibrosis reduces severity of acute-on-chronic pancreatitis in humans[J]. Gastroenterology,2013,145(2):466-475.
22 Della Corte C,Mosca A,Majo F,et al. Nonalcoholic fatty pancreas disease and Nonalcoholic fatty liver disease:more than ectopic fat[J]. Clin Endocrinol(Oxf),2015,83(5):656-662.
23 Melitas C,Meiselman M. Metabolic Pancreatitis:Pancreatic Steatosis,Hypertriglyceridemia,and Associated Chronic Pancreatitis in 3Patients with Metabolic Syndrome[J]. Case Rep Gastroenterol,2018,12(2):331-336.
24 Kashiwagi K,Seino T,Fukuhara S,et al. Pancreatic Fat Content Detected by Computed Tomography and Its Significant Relationship With Intraductal Papillary Mucinous Neoplasm[J]. Pancreas,2018,47(9):1087-1092.
25 Takahashi M,Hori M,Ishigamori R,et al. Fatty pancreas:A possible risk factor for pancreatic cancer in animals and humans[J].Cancer Sci,2018,109(10):3013-3023.
26 Gaujoux S,Cortes A,Couvelard A,et al. Fatty pancreas and increased body mass index are risk factors of pancreatic fistula after pancreaticoduodenectomy[J]. Surgery,2010,148(1):15-23.
27 田景绘,唐艳霞.非酒精性脂肪性肝病与原发性肝癌相关性探讨[J].中国临床新医学,2013,6(8):771-776.
2 Ogilvie RF. The islands of langerhans in 19 cases of obesity[J]. J Pathol Bacteriol,1933,37(3):473-481.
3 Olsen TS. Lipomatosis of the pancreas in autopsy material and its relation to age and overweight[J]. Acta Pathol Microbiol Scand A,1978,86A(5):367-373.
4 Smits MM,van Geenen EJ. The clinical significance of pancreatic steatosis[J]. Nat Rev Gastroenterol Hepatol,2011,8(3):169-177.
5 Matsumoto S,Mori H,Miyake H,et al. Uneven fatty replacement of the pancreas:evaluation with CT[J]. Radiology,1995,194(2):453-458.
6 Sepe PS,Ohri A,Sanaka S,et al. A prospective evaluation of fatty pancreas by using EUS[J]. Gastrointest Endosc,2011,73(5):987-993.
7 Kim SY,Kim H,Cho JY,et al. Quantitative assessment of pancreatic fat by using unenhanced CT:pathologic correlation and clinical implications[J]. Radiology,2014,271(1):104-112.
8 Tranchart H,Gaujoux S,Rebours V,et al. Preoperative CT scan helps to predict the occurrence of severe pancreatic fistula after pancreaticoduodenectomy[J]. Ann Surg,2012,256(1):139-145.
9 Schwenzer NF,Machann J,Martirosian P,et al. Quantification of pancreatic lipomatosis and liver steatosis by MRI:comparison of in/opposed-phase and spectral-spatial excitation techniques[J]. Invest Radiol,2008,43(5):330-337.
10 Lingvay I,Esser V,Legendre JL,et al. Noninvasive quantification of pancreatic fat in humans[J]. J Clin Endocrinol Metab,2009,94(10):4070-4076.
11 Idilman IS,Tuzun A,Savas B,et al. Quantification of liver,pancreas,kidney,and vertebral body MRI-PDFF in non-alcoholic fatty liver disease[J]. Abdom Imaging,2015,40(6):1512-1519.
12 Hu HH,Smith DL Jr,Nayak KS,et al. Identification of brown adipose tissue in mice with fat-water IDEAL-MRI[J]. J Magn Reson Imaging,2010,31(5):1195-1202.
13 Zhao ZZ,Xin LL,Xia JH,et al. Long-term High-fat High-sucrose Diet Promotes Enlarged Islets andβ-Cell Damage by Oxidative Stress in Bama Minipigs[J]. Pancreas,2015,44(6):888-895.
14 Heni M,Machann J,Staiger H,et al. Pancreatic fat is negatively associated with insulin secretion in individuals with impaired fasting glucose and/or impaired glucose tolerance:a nuclear magnetic resonance study[J]. Diabetes Metab Res Rev. 2010,26(3):200-205.
15 Tushuizen ME,Bunck MC,Pouwels PJ,et al. Pancreatic fat content and beta-cell function in men with and without type 2 diabetes[J]. Diabetes Care,2007,30(11):2916-2921.
16 Jeong JS,Kim MK,Han KD,et al. The Association between Pancreatic Steatosis and Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients[J]. Diabetes Metab J,2018,42(5):425-432.
17 Chen DL,Liess C,Poljak A,et al. Phenotypic Characterization of Insulin-Resistant and Insulin-Sensitive Obesity[J]. J Clin Endocrinol Metab,2015,100(11):4082-4091.
18 Di Magno EP,Go VL,Summerskill WH. Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency[J]. N Engl J Med,1973,288(16):813-815.
19 Hellara O,Saad J,Ben Chaabene N,et al. Diffuse primary fat replacement of the pancreas:an unusual cause of steatorrhea[J]. Tunis Med,2013,91(5):359-360.
20 Mathur A,Marine M,Lu D,et al. Nonalcoholic fatty pancreas disease[J]. HPB(Oxford),2007,9(4):312-318.
21 Acharya C,Cline RA,Jaligama D,et al. Fibrosis reduces severity of acute-on-chronic pancreatitis in humans[J]. Gastroenterology,2013,145(2):466-475.
22 Della Corte C,Mosca A,Majo F,et al. Nonalcoholic fatty pancreas disease and Nonalcoholic fatty liver disease:more than ectopic fat[J]. Clin Endocrinol(Oxf),2015,83(5):656-662.
23 Melitas C,Meiselman M. Metabolic Pancreatitis:Pancreatic Steatosis,Hypertriglyceridemia,and Associated Chronic Pancreatitis in 3Patients with Metabolic Syndrome[J]. Case Rep Gastroenterol,2018,12(2):331-336.
24 Kashiwagi K,Seino T,Fukuhara S,et al. Pancreatic Fat Content Detected by Computed Tomography and Its Significant Relationship With Intraductal Papillary Mucinous Neoplasm[J]. Pancreas,2018,47(9):1087-1092.
25 Takahashi M,Hori M,Ishigamori R,et al. Fatty pancreas:A possible risk factor for pancreatic cancer in animals and humans[J].Cancer Sci,2018,109(10):3013-3023.
26 Gaujoux S,Cortes A,Couvelard A,et al. Fatty pancreas and increased body mass index are risk factors of pancreatic fistula after pancreaticoduodenectomy[J]. Surgery,2010,148(1):15-23.
27 田景绘,唐艳霞.非酒精性脂肪性肝病与原发性肝癌相关性探讨[J].中国临床新医学,2013,6(8):771-776.