Lobularity rather than hyperechoic foci/stranding on endoscopic ultrasonography is associated with more severe histological features in chronic pancreatitis
Declaration of conflict of interest: The authors have no conflicts of interest to declare.
Ethical approval: The study was approved by the ethics committee of our hospital (approval number: B210183) and was registered in the University Hospital Medical Information Network (UMIN) clinical trial registry (UMIN ID: 000045497).
Informed consent: The need for informed consent was waived because of the retrospective nature of the study.
Financial support: This work was supported by grants from the Japan Society for the Promotion of Science (JSPS) KAKENHI (19K08444: A.M.; 20J12977: K.Y.; and 19H03698: Y.K.).
Abstract
Background and Aim
Endoscopic ultrasonography (EUS) findings of the pancreatic parenchyma, such as hyperechoic foci/stranding and lobularity, may be associated with the severity of chronic pancreatitis (CP). However, the correlation between parenchymal EUS findings and histology remains unclear. We designed a large-scale retrospective study analyzing over 200 surgical specimens to elucidate the association between parenchymal EUS findings and histological features.
Methods
Clinical data of 221 patients with pancreatobiliary tumors who underwent preoperative EUS and pancreatic surgery between January 2010 and November 2020 were reviewed to investigate the association between parenchymal EUS findings and histological features at the pancreatic body. None of these patients met the definition of CP.
Results
Of the 221 patients, 87 (39.4%), 89 (40.2%), and 45 (20.4%) had normal EUS findings, hyperechoic foci/stranding without lobularity, and hyperechoic foci/stranding with lobularity, respectively. In the multivariate analyses, parenchymal EUS findings significantly correlated with histological CP findings of fibrosis, inflammation, and atrophy (hyperechoic foci/stranding without lobularity vs hyperechoic foci/stranding with lobularity, odds ratio [95% confidence interval]: 4.1 [2.2–7.9] vs 31.3 [9.3–105.6], Ptrend < 0.001; 3.9 [1.9–8.2] vs 21.8 [8.0–59.4], Ptrend < 0.001; and 4.0 [2.0–7.8] vs 22.9 [7.0–74.5], Ptrend < 0.001, respectively). Further, a trend toward higher histological grade was observed in the following order: normal findings, hyperechoic foci/stranding without lobularity, and hyperechoic foci/stranding with lobularity.
Conclusions
Endoscopic ultrasonography findings of the pancreatic parenchyma may be associated with the histological conditions in CP, such as pancreatic fibrosis, inflammation, and atrophy. Lobularity reflects more severe histological conditions than does hyperechoic foci/stranding.
Open Research
Data availability statement
All the data analyzed in the current study are available from the corresponding author (A.M.) on reasonable request.
