Shobassy Mazen, Husainat Nedaa, Tabash Abdalaziz, Patel Kalpesh, El-Serag Hashem B, Othman Mohamed O
Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
Gastroenterol Res Pract. 2019 Aug 14;2019:5290642. doi: 10.1155/2019/5290642. eCollection 2019.
Fecal elastase-1 (FE-1) as a screening test for exocrine pancreatic insufficiency (EPI) is gaining popularity in clinical practice. The role of imaging in patients with FE-1-related suspicion of EPI remains unclear. The aim of this study was to characterize endoscopic ultrasound (EUS) findings for patients with low FE-1.
A retrospective cross-sectional study was performed in 40 patients who had low FE-1 and underwent EUS to evaluate the pancreas. We obtained data on demographic and lifestyle factors, EUS findings, and histopathology results. We compared these variables between patients with FE-1 < 100 mcg/g vs. 100-200 mcg/g.
Most patients (82.5%) established one or more new diagnoses from EUS. Diagnoses included: definitive chronic pancreatitis ( = 29, 72.5%), fatty pancreas ( = 9, 22.5%), and pancreatic solid mass or cyst ( = 9, 22.5%). Half ( = 4) of the solid or cystic lesions were neoplastic. All patients with a solid pancreatic mass also had concurrent chronic pancreatitis. There were no significant differences in EUS findings or demographic or lifestyle factors between groups with FE-1 < 100 mcg/g vs. 100-200 mcg/g.
Chronic pancreatitis is the most common EUS finding in patients with low FE-1 levels. EUS appears helpful in determining the cause of EPI in most patients with low FE-1 and may detect unsuspected pancreatic neoplasia.
粪便弹性蛋白酶-1（FE-1）作为外分泌性胰腺功能不全（EPI）的筛查试验在临床实践中越来越受欢迎。成像检查在FE-1相关的EPI疑似患者中的作用仍不明确。本研究的目的是描述FE-1水平低的患者的内镜超声（EUS）检查结果。
对40名FE-1水平低且接受EUS检查以评估胰腺的患者进行了一项回顾性横断面研究。我们获取了人口统计学和生活方式因素、EUS检查结果以及组织病理学结果的数据。我们比较了FE-1＜100 mcg/g与100 - 200 mcg/g患者之间的这些变量。
大多数患者（82.5%）通过EUS确诊了一种或多种新疾病。诊断包括：确诊的慢性胰腺炎（n = 29，72.5%）、胰腺脂肪变（n = 9，22.5%）以及胰腺实性肿块或囊肿（n = 9，22.5%）。实性或囊性病变中有一半（n = 4）为肿瘤性病变。所有胰腺实性肿块患者均同时患有慢性胰腺炎。FE-1＜100 mcg/g与100 - 200 mcg/g的患者组之间，EUS检查结果、人口统计学或生活方式因素均无显著差异。
慢性胰腺炎是FE-1水平低的患者中最常见的EUS检查结果。EUS似乎有助于确定大多数FE-1水平低的患者的EPI病因，并且可能检测出未被怀疑的胰腺肿瘤。
