The Differential Diagnosis Of Mass-type Chronic Pancreatitis With Pancreatic Carcinoma

Objective To discuss the differential diagnosis of mass-type chronic pancreatitis (MTCP) with pancreatic carcinoma. Method Retrospectively analyzed the clinical data of 16 patients with MTCP and 32 patients with pancreatic carcinoma from January 1997 to July 2004 in our hospital. Results CA19-9 was the best diagnostic index tumor markers; its sensitivity, specificity and efficiency were 80.0%, 92.9% and 84.6%, respectively. Combination assay of tumor markers was not helpful to improve the sensitivity of pancreatic carcinoma diagnosis. MTCP was more easily to have a parenchymal atrophy than pancreatic carcinoma (P < 0.01). The pancreatic duct of MTCP often have an irregular dilatation across the whole segment of the lesion (P<0.01), while the pancreatic duct of pancreatic carcinoma often have a continuously smooth dilatation with an abrupt interruption at the site of the tumor (P<0.05). The commonbile duct of MTCP often tapering at the lesion with smooth dilatation up the stricture (P<0.05), while the common bile duct of pancreatic carcinoma often have an abrupt interruption of the dilated common bile at the site of the tumor (P<0.05). The dilatation of the two major ducts between MTCP and pancreatic carcinoma was not significant (P > 0.05). Conclusions CA19-9 and imaging examinationchanges are helpful in differential diagnosis of MTCP and pancreatic carcinoma.