Yamamiya Akira, Irisawa Atsushi, Tominaga Keiichi, Tsuchida Kohei, Sugaya Takeshi, Tsunemi Misako, Hoshi Koki, Jinnai Hidehito, Yamabe Akane, Izawa Naoya, Iwasaki Mari, Takimoto Yoichi, Kanamori Akira, Nagashima Kazunori, Minaguchi Takahito, Kashima Ken, Kunogi Yasuhito, Sato Ai, Goda Kenichi, Iijima Makoto, Haruyama Yasuo
Department of Gastroenterology, Dokkyo Medical University School of Medicine, 880 Kitakobayashi Mibu, Tochigi 321-0293, Japan.
Department of Gastroenterology, Dokkyo Medical University Nikko Medical Center, 632 Takatoku Nikko, Tochigi 321-2593, Japan.
Diagnostics (Basel). 2021 Mar 3;11(3):431. doi: 10.3390/diagnostics11030431.
In 2009, diagnostic criteria for early chronic pancreatitis (DCECP2009) were proposed by the Japan Pancreas Society. This study aimed to evaluate the interobserver reliability (IOR) of endoscopic ultrasound (EUS) criteria for diagnosis of early chronic pancreatitis (ECP) between DCECP2009 and 2019 diagnostic criteria for ECP (DCECP2019) to assess the validity of the revision from the perspective of EUS findings. Among patients who underwent a detailed observation of the pancreas by EUS at our institution between January 2018 and March 2019, EUS images of 97 patients were extracted. Images were reviewed by 12 gastrointestinal endoscopy experts (eight pancreatologists, group A and four nonpancreatologists, group B). The overall kappa (K)-values for the IOR of the DCECP2009 EUS criteria were 0.424 and 0.563:0.231 for groups A:B, whereas the overall K-values for the DCECP2019 criteria were 0.618, and 0.733:0.442 for groups A:B. Regarding changes in the final diagnosis of ECP based on clinical features and EUS findings, 20 cases were definite ECP, 53 were probable ECP, and 24 were normal according to DCECP2009. In contrast, seven were definite ECP, 19 were probable ECP, and 71 were normal according to DECEP2019. IOR of DCECP2019 was higher than that of DCECP2009, which indicates an improvement in precision.
2009年，日本胰腺学会提出了早期慢性胰腺炎的诊断标准（DCECP2009）。本研究旨在评估2009年早期慢性胰腺炎诊断标准（DCECP2009）与2019年早期慢性胰腺炎诊断标准（DCECP2019）之间，内镜超声（EUS）诊断早期慢性胰腺炎（ECP）标准的观察者间可靠性（IOR），以从EUS检查结果的角度评估修订版的有效性。在2018年1月至2019年3月期间在本机构接受EUS对胰腺进行详细观察的患者中，提取了97例患者的EUS图像。由12位胃肠内镜专家（8位胰腺病学家，A组；4位非胰腺病学家，B组）对图像进行了评估。DCECP2009 EUS标准的IOR总体kappa（K）值分别为0.424和0.563（A组对B组为0.231），而DCECP2019标准的总体K值分别为0.618和0.733（A组对B组为0.442）。基于临床特征和EUS检查结果的ECP最终诊断变化方面，根据DCECP2009，20例为确诊ECP，53例为可能的ECP，24例正常。相比之下，根据DECEP2019，7例为确诊ECP，19例为可能的ECP，71例正常。DCECP2019的IOR高于DCECP2009，这表明诊断准确性有所提高。
