Pancreatic calcifications associate with diverse aetiological risk factors in patients with chronic pancreatitis: A multicentre study of 1500 cases

Abstract

Objective: Pancreatic calcifications is a common finding in patients with chronic pancreatitis (CP), but the underlying pathophysiology is incompletely understood. Past studies for risk factors of calcifications have generally been focused on single parameters or limited by small sample sizes. The aim of this study was to explore several patient and disease characteristics and their associations with pancreatic calcifications in a large cohort of CP patients with diverse etiological risk factors. Methods: This was a multicenter, cross-sectional study including 1509 patients with CP from the Scandinavian and Baltic countries. Patient and disease characteristics were compared for patients with calcifications (n=912) vs. without calcifications (n=597). Multivariable logistic regression was performed to assess the parameters independently associated with calcifications. Results: The mean age of patients was 53.9±14.5 years and 1006 (67%) were men. The prevalence of calcifications was 60.4% in the overall patient cohort, but highly variable between patients with different etiological risk factors (range: 2-69%). On multivariate analysis, alcoholic etiology (OR 1.76 [95% CI, 1.39-2.24]; p<0.001) and smoking (OR 1.77 [95% CI, 1.39-2.26], p<0.001) were positively associated with the presence of calcifications, while an autoimmune etiology was negatively associated with calcifications (OR 0.15 [95% CI, 0.08-0.27], p<0.001). Patients with pancreatic calcifications were more likely to have undergone pancreatic duct stenting (OR 1.59 [95%CI, 1.16-2.19], p=0.004). Conclusion: The presence of pancreatic calcifications is associated with etiological risk factors in patients with CP. This observation attest to the understanding of CP as a complex disease and may have implications for disease classification.

Aetiological risk factors are associated with distinct imaging findings in patients with chronic pancreatitis: A study of 959 cases from the Scandinavian Baltic Pancreatic Club (SBPC) imaging database

“…The SBPC study group has recently published several works exploring etiological factors and associations with clinical outcomes [12,13,14,15]. Findings from the present study are in line with earlier reports from the same cohort.…”

“…is not yet reached. SBPC has collected a large, multicentre-database comprising subjects with CP [12,13,14,15,16]. Standards used in the SBPC imaging module was developed to adhere to the most commonly used imaging systems [3,9].…”

Multiple risk factors for diabetes mellitus in patients with chronic pancreatitis: A multicentre study of 1117 cases

“…The dataset included registrations from 11 centres in eight countries, a detailed description of the methodology and study protocol of the SBPC database is provided in a previous publication. 11,12 The M-ANNHEIM classification system was used to define CP and only patients with a definite diagnosis of CP (histology and/or pancreatic calcifications and/or marked pancreatic duct pathology (Cambridge grade 3 or 4)) were included. 13 These criteria were chosen to ensure a uniform characterization of our study cohort and to exclude patients with DM following acute pancreatitis (but without definite evidence of CP).…”

“…This database include data from a multicentre prospective registration of patients with CP initiated on 1 February 2016, 11 we derived data for the present study as of 12 August 2019. The dataset included registrations from 11 centres in eight countries, a detailed description of the methodology and study protocol of the SBPC database is provided in a previous publication 11,12 . The M‐ANNHEIM classification system was used to define CP and only patients with a definite diagnosis of CP (histology and/or pancreatic calcifications and/or marked pancreatic duct pathology (Cambridge grade 3 or 4)) were included 13 .…”

Mass-forming pancreatitis versus pancreatic ductal adenocarcinoma: CT and MR imaging for differentiation

“…Parenchymal calcifications are seen in approximately 60% of CP patients [ 20 ] (Fig. 4 ) and the combination of diffused parenchymal calcifications with ductal calcifications, atrophy and cystic lesions is quite specific for the diagnosis of CP [ 21 ].…”