Institute for Translational Medicine, Medical School, Szentágothai Research Centre, University of Pécs, Pécs, Hungary.
Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary.
Sci Rep. 2021 Jan 14;11(1):1367. doi: 10.1038/s41598-020-80532-6.
Chronic pancreatitis (CP) is an end-stage disease with no specific therapy; therefore, an early diagnosis is of crucial importance. In this study, data from 1315 and 318 patients were analysed from acute pancreatitis (AP) and CP registries, respectively. The population from the AP registry was divided into AP (n = 983), recurrent AP (RAP, n = 270) and CP (n = 62) groups. The prevalence of CP in combination with AP, RAP2, RAP3, RAP4 and RAP5 + was 0%, 1%, 16%, 50% and 47%, respectively, suggesting that three or more episodes of AP is a strong risk factor for CP. Laboratory, imaging and clinical biomarkers highlighted that patients with RAP3 + do not show a significant difference between RAPs and CP. Data from CP registries showed 98% of patients had at least one AP and the average number of episodes was four. We mimicked the human RAPs in a mouse model and found that three or more episodes of AP cause early chronic-like morphological changes in the pancreas. We concluded that three or more attacks of AP with no morphological changes to the pancreas could be considered as early CP (ECP).The new diagnostic criteria for ECP allow the majority of CP patients to be diagnosed earlier. They can be used in hospitals with no additional costs in healthcare.
慢性胰腺炎（CP）是一种无特效疗法的终末期疾病；因此，早期诊断至关重要。本研究分别对急性胰腺炎（AP）和 CP 登记处的 1315 例和 318 例患者的数据进行了分析。AP 登记处的人群分为 AP（n=983）、复发性 AP（RAP，n=270）和 CP（n=62）组。CP 与 AP、RAP2、RAP3、RAP4 和 RAP5+联合的患病率分别为 0%、1%、16%、50%和 47%，提示三次或更多次 AP 发作是 CP 的一个强烈危险因素。实验室、影像学和临床生物标志物突出表明，RAP3+患者在 RAP 与 CP 之间没有显著差异。CP 登记处的数据显示，98%的患者至少有一次 AP，发作次数平均为四次。我们在小鼠模型中模拟了人类 RAPs，发现三次或更多次 AP 会导致胰腺早期出现类似慢性的形态变化。我们得出结论，三次或更多次无胰腺形态变化的 AP 发作可被视为早期 CP（ECP）。新的 ECP 诊断标准可使大多数 CP 患者更早得到诊断。它们可在没有额外医疗成本的医院中使用。
