Department of Surgery, University Hospital Mannheim, University Heidelberg, Theodor-Kutzer-Ufer 1-3, Mannheim, Germany.
Pancreatology. 2013 May-Jun;13(3):243-9. doi: 10.1016/j.pan.2013.03.014. Epub 2013 Apr 6.
Pancreatic ductal adenocarcinoma (PDAC) is characterized by its poor prognosis, and some benign conditions and syndromes, including chronic pancreatitis (CP), are risk factors for pancreatic carcinoma. However, the differential diagnosis of CP from PDAC is difficult for clinicians because PDAC frequently causes inflammation within the pancreas. Therefore, patients with CP exhibit not only an elevated risk of cancer, but they are also in danger of underdiagnosis.
The present study retrospectively analyzed 29 patients with pancreatic cancer who fulfilled our definition of "chronic pancreatitis" to identify characteristics to aid in the differential diagnosis between chronic pancreatitis with and without pancreatic cancer. All parameters were subjected to univariate analysis.
We identified several factors that differed significantly between the CP patients and patients with CP and synchronous PDAC, and these characteristics were used to develop a diagnostic algorithm. The performance of the algorithm was externally validated in a different panel of patients from the Department of Surgery, Medical Faculty Mannheim.
The present study succeeded in identifying characteristics that significantly differed in patients with and without PDAC in CP. These characteristics were integrated in a diagnostic algorithm that might help to improve diagnostic of PDAC in CP.
胰腺导管腺癌（PDAC）的预后较差，一些良性疾病和综合征，包括慢性胰腺炎（CP），是胰腺癌的危险因素。然而，由于 PDAC 常导致胰腺内炎症，因此临床医生很难将 CP 与 PDAC 区分开来。因此，CP 患者不仅癌症风险升高，而且还存在漏诊的危险。
本研究回顾性分析了 29 例符合我们“慢性胰腺炎”定义的胰腺癌患者，以确定有助于区分有和无胰腺癌的慢性胰腺炎的鉴别诊断特征。对所有参数进行单因素分析。
我们确定了 CP 患者和 CP 合并同步 PDAC 患者之间存在显著差异的几个因素，并使用这些特征开发了一个诊断算法。该算法的性能在曼海姆医学系外科的另一组患者中进行了外部验证。
本研究成功地确定了 CP 患者中有无 PDAC 患者之间存在显著差异的特征。这些特征被整合到一个诊断算法中，可能有助于提高 CP 中 PDAC 的诊断。
