TY - JOUR
T1 - Pancreatitis and pancreatic cancer: A case of the chicken or the egg
AU - Umans, Devica S.
AU - Hoogenboom, Sanne A.
AU - Lekkerkerker, Selma J.
AU - Umans, Devica S.
AU - Sissingh, Noor J.
AU - Sissingh, Noor J.
AU - van Hooft, Jeanin E.
AU - Verdonk, Robert C.
N1 - Publisher Copyright: ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
PY - 2021/6/21
Y1 - 2021/6/21
N2 - Acute pancreatitis (AP), chronic pancreatitis (CP) and pancreatic cancer are three distinct pancreatic diseases with different prognoses and treatment options. However, it may be difficult to differentiate between benign and malignant disease. AP may be a first symptom of pancreatic cancer, particularly in patients between the ages of 56 and 75 with presumed idiopathic AP who had a concomitant diagnosis of new-onset diabetes mellitus or patients who present with CP at diagnosis of AP. In these patients, additional imaging is warranted, preferably by endoscopic ultrasonography. CP may lead to pancreatic cancer through oncogenic mutations, mostly in patients with hereditary CP, and in patients in whom risk factors for pancreatic cancer (e.g., nicotine and alcohol abuse) are also present. Patients with PRSS1-mediated CP and patients with a history of autosomal dominant hereditary CP without known genetic mutations may be considered for surveillance for pancreatic cancer. Pancreatic inflammation may mimic pancreatic cancer by appearing as a focal mass-forming lesion on imaging. Differentiation between the above mentioned benign and malignant disease may be facilitated by specific features like the duct-penetrating sign and the duct-to-parenchyma ratio. Research efforts are aimed towards developing a superior discriminant between pancreatitis and pancreatic cancer in the form of imaging modalities or biomarkers. This may aid clinicians in timely diagnosing pancreatic cancer in a potentially curable stage.
AB - Acute pancreatitis (AP), chronic pancreatitis (CP) and pancreatic cancer are three distinct pancreatic diseases with different prognoses and treatment options. However, it may be difficult to differentiate between benign and malignant disease. AP may be a first symptom of pancreatic cancer, particularly in patients between the ages of 56 and 75 with presumed idiopathic AP who had a concomitant diagnosis of new-onset diabetes mellitus or patients who present with CP at diagnosis of AP. In these patients, additional imaging is warranted, preferably by endoscopic ultrasonography. CP may lead to pancreatic cancer through oncogenic mutations, mostly in patients with hereditary CP, and in patients in whom risk factors for pancreatic cancer (e.g., nicotine and alcohol abuse) are also present. Patients with PRSS1-mediated CP and patients with a history of autosomal dominant hereditary CP without known genetic mutations may be considered for surveillance for pancreatic cancer. Pancreatic inflammation may mimic pancreatic cancer by appearing as a focal mass-forming lesion on imaging. Differentiation between the above mentioned benign and malignant disease may be facilitated by specific features like the duct-penetrating sign and the duct-to-parenchyma ratio. Research efforts are aimed towards developing a superior discriminant between pancreatitis and pancreatic cancer in the form of imaging modalities or biomarkers. This may aid clinicians in timely diagnosing pancreatic cancer in a potentially curable stage.
KW - Chronic Pancreatitis
KW - Exocrine pancreatic
KW - Pancreas
KW - Pancreatic diseases
KW - Pancreatic neoplasms
KW - Pancreatitis
UR - http://www.scopus.com/inward/record.url?scp=85108646223&partnerID=8YFLogxK
U2 - https://doi.org/10.3748/wjg.v27.i23.3148
DO - https://doi.org/10.3748/wjg.v27.i23.3148
M3 - Review article
C2 - 34163103
SN - 1007-9327
VL - 27
SP - 3148
EP - 3157
JO - World journal of gastroenterology
JF - World journal of gastroenterology
IS - 23
ER -