Prospective study of early chronic pancreatitis diagnosed based on the Japanese diagnostic criteria

Masamune A, Tatsuhide Nabeshima, Nabeshima T, Kazuhiro Kikuta, Kikuta K, Shin Hamada, Hamada S, Eriko Nakano, Nakano E, Kume K, Kiyoshi Kume, Kanno A, Atsushi Kanno, Sato A, Ai Sato, Yuichi Tachibana, Tachibana Y, Inatomi O, Osamu Inatomi, Satoshi Yamamoto, Yamamoto S, Tsukasa Ikeura, Ikeura T, Seiji Futagami, Futagami S, Taguchi M, Masashi Taguchi, Keiji Hanada, Hanada K, Shimizu K, Kyoko Shimizu, Kageoka M, Masanobu Kageoka, Tomotaka Saito, Saito T, Eguchi T, Takaaki Eguchi, Kensuke Kubota, Kubota K, Takenaka M, Mamoru Takenaka, Mima A, Atsushi Mima, Irisawa A, Atsushi Irisawa, Ito T, Tetsuhide Ito, Andoh A, Akira Andoh, Inui K, Kazuo Inui, Yoshifumi Takeyama, Takeyama Y, Hiroki Yamaue, Yamaue H, Okazaki K, Kazuichi Okazaki, Tooru Shimosegawa, Shimosegawa T
Journal of gastroenterology · 2019 · vol. 54(10) , pp. 928–935 · doi:10.1007/s00535-019-01602-9 · PMID:31270692
Non-randomised trial OA: closed
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This prospective study evaluated Japanese diagnostic criteria for early chronic pancreatitis, finding that only 4.8% of patients progressed to definite chronic pancreatitis within two years, with alcohol use and smoking associated with progression.

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Abstract

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: 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: 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: 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: UMIN000015992.

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MeSH descriptors

Pancreatitis, Chronic Adult Aged Aged, 80 and over Alcoholism Alcoholism Cholangiopancreatography, Magnetic Resonance Disease Progression Early Diagnosis Female Follow-Up Studies Humans Male Middle Aged Pancreatitis, Chronic Pancreatitis, Chronic Prognosis Prospective Studies Risk Factors Smoking

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