TY - JOUR
T1 - Clinical characteristics of pancreatic cancer presenting with acute pancreatitis
T2 - a propensity-matched cohort study
AU - Shi, Jiaqi
AU - Nie, Shuang
AU - Shi, Zhao
AU - Liu, Kun
AU - Zhou, Quan
AU - Wang, Xuan
AU - Jiang, Yihang
AU - Zhang, Song
AU - Peng, Chunyan
AU - Lv, Ying
AU - Tang, Bei
AU - Cheng, Hao
AU - Qiu, Yudong
AU - Li, Hongzhen
AU - Yu, Yuanyuan
AU - Kong, Bo
AU - Friess, Helmut
AU - Liu, Song
AU - Wang, Lei
AU - Zou, Xiaoping
AU - Shen, Shanshan
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.
PY - 2025
Y1 - 2025
N2 - Background and aim: The symptoms of pancreatic cancer (PC) are usually nonspecific or absent, and the early diagnosis remains challenging. 7–14% of PC patients present initially with acute pancreatitis (AP). This study aims to distinguish the PC patients initially presenting with AP from simple AP patients, further evaluating the role of endoscopic ultrasound (EUS) in the early diagnosis. Methods: We retrospectively evaluated 1376 consecutive patients with AP between 2010 and 2023.To overcome selection bias, we used propensity score matching between PC patients initially presenting with AP and non-cancer-related AP patients. Clinical information, especially EUS were collected for comparison. Results: After matching, 72 patients (PC group) and 216 patients (AP group) were included. The unknown etiology in the PC group was significantly higher than that in the AP group (54.2% vs. 27.8%). Regarding initial symptoms, non-cancer-related AP patients exhibited significantly more abdominal distension, vomiting and fever compared to the PC group (p < 0.05). In terms of lab results, PC group patients had lower serum amylase (p < 0.001), but higher CA19-9, CA72-4, and CA242 levels when compared to AP group patients (p < 0.001). Additionally, AP group patients had more systematic and local complications, and the severity of AP was much higher than that of PC group patients. Moreover, PC patients exhibited more frequent imaging findings, such as pancreatic duct dilation or atrophy, and enlarged lymph nodes (p < 0.05). Notably, the EUS examination in PC patients missing diagnosis initially and PC patients presenting with relapsed AP showed more sensitive results and more detective rates. Conclusion: Pancreatic cancer patients presenting initially with acute pancreatitis tend to exhibit mild, recurrent pancreatitis than common AP patients. EUS holds potential diagnostic value in detecting pancreatic cancer in patients with initially negative cross-sectional imaging and recurrent pancreatitis.
AB - Background and aim: The symptoms of pancreatic cancer (PC) are usually nonspecific or absent, and the early diagnosis remains challenging. 7–14% of PC patients present initially with acute pancreatitis (AP). This study aims to distinguish the PC patients initially presenting with AP from simple AP patients, further evaluating the role of endoscopic ultrasound (EUS) in the early diagnosis. Methods: We retrospectively evaluated 1376 consecutive patients with AP between 2010 and 2023.To overcome selection bias, we used propensity score matching between PC patients initially presenting with AP and non-cancer-related AP patients. Clinical information, especially EUS were collected for comparison. Results: After matching, 72 patients (PC group) and 216 patients (AP group) were included. The unknown etiology in the PC group was significantly higher than that in the AP group (54.2% vs. 27.8%). Regarding initial symptoms, non-cancer-related AP patients exhibited significantly more abdominal distension, vomiting and fever compared to the PC group (p < 0.05). In terms of lab results, PC group patients had lower serum amylase (p < 0.001), but higher CA19-9, CA72-4, and CA242 levels when compared to AP group patients (p < 0.001). Additionally, AP group patients had more systematic and local complications, and the severity of AP was much higher than that of PC group patients. Moreover, PC patients exhibited more frequent imaging findings, such as pancreatic duct dilation or atrophy, and enlarged lymph nodes (p < 0.05). Notably, the EUS examination in PC patients missing diagnosis initially and PC patients presenting with relapsed AP showed more sensitive results and more detective rates. Conclusion: Pancreatic cancer patients presenting initially with acute pancreatitis tend to exhibit mild, recurrent pancreatitis than common AP patients. EUS holds potential diagnostic value in detecting pancreatic cancer in patients with initially negative cross-sectional imaging and recurrent pancreatitis.
KW - Acute pancreatitis
KW - Endoscopic ultrasound
KW - Pancreatic atrophy
KW - Pancreatic cancer
KW - Pancreatic duct dilation
KW - Recurrent pancreatitis
UR - http://www.scopus.com/inward/record.url?scp=105002606058&partnerID=8YFLogxK
U2 - 10.1007/s00464-025-11654-z
DO - 10.1007/s00464-025-11654-z
M3 - Article
AN - SCOPUS:105002606058
SN - 0930-2794
JO - Surgical Endoscopy
JF - Surgical Endoscopy
M1 - e5908
ER -
