Clinical significance of pancreatic calcifications: a 15-year single-center observational study

Abstract

Objectives: Pancreatic calcifications (PC) are considered specific for chronic pancreatitis (CP), but PC may also be present in non-CP diseases. The aims are to understand the pattern of calcifications in different diseases and to determine they were related to malignant diseases.

Methods: A retrospective study was performed including patients with PC or CP undergoing surgery in the Department of General Surgery of Ruijin Hospital from January 2003 to June 2018.

Results: PC were observed in 168 (4.5%) of the 3755 patients with pancreatic lesions treated during the study period. The majority of patients with PC had three kinds of CP (73.2%) while 26.8% had other five kinds of non-CP diseases. In patients with non-CP diseases, the incidence of PC in malignant intraductal papillary mucinous neoplasm (IPMN) was significantly higher than benign IPMN (8.3% vs. 0.7%, p = 0.004). In patients of CP with pancreatic mass (n = 81), PC (Odds ratio = 28.6, p = 0.000), advanced age (> 55 years) and parenchymal atrophy were independent predictors for malignancy. In patients of CP without pancreatic mass (n = 110), there were 82 cases (74.5%) with PC and 5 cases (4.5%) with pancreatic ductal adenocarcinoma. The regression model of risk factors was not successful.

Conclusions: The disease spectrum with PC was very diverse. PC may be related to malignant IPMN in non-CP diseases and is related to malignancy in the patients of CP with pancreatic mass and indications for resection.

Keywords: Chronic pancreatitis; Malignancy; Non-chronic pancreatitis diseases; Pancreatic calcifications.

Fig. 1

Disease spectrum of patients with pancreatic calcifications. CP Chronic PANCREATITIS, IPMN intraductal papillary mucinous neoplasm, PDAC pancreatic ductal adenocarcinoma, SPT solid pseudopapillary tumors, SCN serous cystic neoplasm, P-NN pancreatic neuroendocrine neoplasm, MCN mucinous cystic neoplasm