Prospective study of early chronic pancreatitis diagnosed based on the Japanese diagnostic criteria.
Adult
Aged
Aged, 80 and over
Alcoholism
/ complications
Cholangiopancreatography, Magnetic Resonance
Disease Progression
Early Diagnosis
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pancreatitis, Chronic
/ diagnosis
Prognosis
Prospective Studies
Risk Factors
Smoking
/ adverse effects
Tomography, X-Ray Computed
Young Adult
Alcohol
Diagnosis
Endoscopic ultrasonography
Functional dyspepsia
Smoking
Journal
Journal of gastroenterology
ISSN: 1435-5922
Titre abrégé: J Gastroenterol
Pays: Japan
ID NLM: 9430794
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
13
05
2019
accepted:
24
06
2019
pubmed:
5
7
2019
medline:
22
7
2020
entrez:
5
7
2019
Statut:
ppublish
Résumé
Chronic pancreatitis (CP) is a fibro-inflammatory disease of the pancreas. Early diagnosis and intervention, before CP becomes established and irreversible, are essential to improve the long-term outcomes. The world's first diagnostic criteria for early CP were proposed in Japan in 2009, but their clinical utility remains elusive. This study aimed to clarify whether patients with early CP progress to definite CP. This is a multicenter, prospective study. Patients diagnosed as having early CP according to the Japanese diagnostic criteria were prospectively followed for 2 years. Clinical profiles including symptoms, drinking and smoking status, laboratory data, imaging findings and treatments were analyzed. Among the 83 patients who completed the 2-year follow-up period, four (4.8%) patients progressed to definite CP. The diagnosis of 48 (57.8%) patients was unchanged, and that of 31 (37.3%) patients was downgraded. All the four progressive patients were male, alcohol-related, smokers (3 current and 1 ever), and continued drinking. Comparison of the clinical profiles between the progression group (n = 4) and non-progression group (n = 79) revealed that etiology (alcohol-related), smoking status and presence of acute pancreatitis episodes were associated with the progression to definite CP. The Japanese diagnostic criteria could identify some patients before the progression to definite CP, while the majority of the patients did not progress. UMIN000015992.
Sections du résumé
BACKGROUND
BACKGROUND
Chronic pancreatitis (CP) is a fibro-inflammatory disease of the pancreas. Early diagnosis and intervention, before CP becomes established and irreversible, are essential to improve the long-term outcomes. The world's first diagnostic criteria for early CP were proposed in Japan in 2009, but their clinical utility remains elusive. This study aimed to clarify whether patients with early CP progress to definite CP.
METHODS
METHODS
This is a multicenter, prospective study. Patients diagnosed as having early CP according to the Japanese diagnostic criteria were prospectively followed for 2 years. Clinical profiles including symptoms, drinking and smoking status, laboratory data, imaging findings and treatments were analyzed.
RESULTS
RESULTS
Among the 83 patients who completed the 2-year follow-up period, four (4.8%) patients progressed to definite CP. The diagnosis of 48 (57.8%) patients was unchanged, and that of 31 (37.3%) patients was downgraded. All the four progressive patients were male, alcohol-related, smokers (3 current and 1 ever), and continued drinking. Comparison of the clinical profiles between the progression group (n = 4) and non-progression group (n = 79) revealed that etiology (alcohol-related), smoking status and presence of acute pancreatitis episodes were associated with the progression to definite CP.
CONCLUSIONS
CONCLUSIONS
The Japanese diagnostic criteria could identify some patients before the progression to definite CP, while the majority of the patients did not progress.
TRIAL REGISTRATION NUMBER
BACKGROUND
UMIN000015992.
Identifiants
pubmed: 31270692
doi: 10.1007/s00535-019-01602-9
pii: 10.1007/s00535-019-01602-9
doi:
Types de publication
Clinical Trial
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
928-935Subventions
Organisme : Japan Pancreas Society
ID : 1
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Références
Gut. 1999 Sep;45(3):317-22
pubmed: 10446089
Clin Gastroenterol Hepatol. 2009 Nov;7(11 Suppl):S15-7
pubmed: 19896091
Am J Gastroenterol. 2017 Sep;112(9):1366-1372
pubmed: 28762376
Pancreatology. 2019 Jun;19(4):500-506
pubmed: 30910452
Am J Gastroenterol. 2012 Jul;107(7):1096-103
pubmed: 22613906
Gastroenterology. 2015 Nov;149(6):1490-1500.e1
pubmed: 26299411
J Gastroenterol. 2017 Aug;52(8):992-1000
pubmed: 28130705
Pancreatology. 2014 Nov-Dec;14(6):490-6
pubmed: 25224249
Pancreatology. 2018 May 21;:
pubmed: 29793839
Gastroenterology. 2001 Feb;120(3):682-707
pubmed: 11179244
Pancreatology. 2016 Mar-Apr;16(2):218-24
pubmed: 26924663
Lancet. 2016 May 7;387(10031):1957-66
pubmed: 26948434
Nat Rev Dis Primers. 2017 Sep 07;3:17060
pubmed: 28880010
Pancreas. 2007 Nov;35(4):320-6
pubmed: 18090237
J Gastroenterol. 2010 Jun;45(6):584-91
pubmed: 20422433
Arch Intern Med. 2009 Jun 8;169(11):1035-45
pubmed: 19506173
Pancreatology. 2018 Oct;18(7):774-784
pubmed: 30119992
Pancreas. 2013 May;42(4):578-83
pubmed: 23508016