Clinical characteristics and diagnostic factors of tumor-associated acute pancreatitis: A comparative analysis of early vs delayed diagnosis

doi:10.4251/wjgo.v17.i8.109743

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Aug 15, 2025 (publication date) through Aug 17, 2025

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Oncol. Aug 15, 2025; 17(8): 109743
Published online Aug 15, 2025. doi: 10.4251/wjgo.v17.i8.109743

Table 1 The baseline characteristics of patients with tumor-associated acute pancreatitis, n (%)

Characteristics	Total (n = 167)	The early-diagnosis group (n = 75)	The delayed-diagnosis group (n = 92)	P value
Age, median (IQR), year	63.9 (54.1-68.0)	57.3 (54.5-62.5)	68.2 (60.1-73.0)	0.02^a
Sex (F/M)	97/70	41/34	56/36	0.59
BMI, median (IQR)	21.2 (20.3-22.4)	21.1 (20.74-22.66)	21.0 (20.3-22.1)	0.20
Smoking history				> 0.99
Yes	75 (44.9)	32 (42.7)	43 (46.7)
No	92 (55.1)	43 (57.3)	49 (53.4)
Alcohol history
Yes	80 (47.9)	15 (20.0)	65 (70.7)	< 0.01^a
No	87 (52.1)	60 (80.0)	27 (29.3)
Diabetes history				< 0.01^a
Yes	53 (31.7)	6 (8.0)	47 (51.1)
No	114 (68.3)	69 (92.0)	45 (48.9)
Classification of AP
MAP	97 (58.1)	40 (53.3)	57 (70.0)	0.33
MSAP	57(34.1)	31(41.3)	26(28.2)
SAP	13 (7.8)	4 (5.4)	9 (9.8)
Family history of pancreatic cancer				> 0.99
Yes	10 (6.0)	3 (4.0)	7 (7.6)
No	157 (94.0)	72 (96.0)	85 (92.4)
Admission way				0.38
Emergency admission	47 (28.4)	14 (18.7)	33 (35.8)
Outpatient admission	120 (71.6)	61 (81.3)	59 (64.2)

^aP < 0.05.

F/M: Female/male; IQR: Inter quartile range; BMI: Body mass index; AP: Acute pancreatitis; MAP: Mild Acute pancreatitis; MSAP: Moderate severe acute pancreatitis; SAP: Severe acute pancreatitis.

Table 2 Characteristics of diagnosis and treatment in admission and post-admission, n (%)

Characteristics	Total (n = 167)	The early-diagnosis group (n = 75)	The delayed-diagnosis group (n = 92)	P value
Symptoms				0.01^a
Pain	132 (79.0)	51 (68.0)	81 (88.0)
Nausea or vomit	47 (28.1)	33 (44.0)	14 (15.2)
Fever	80 (47.9)	38 (50.7)	42 (45.7)
Amylase, median, IQR (U/L)	247.3 (142.5-376.8)	289.5 (187.3-453.2)	231.1 (116.7-327.2)	0.41
Lipase, median, IQR (U/L)	475.6 (221.7-834.6)	411.5 (216.7-943.8)	436.9 (203.6-1056.0)	0.37
CA19-9, median, IQR (U/mL)	72.5 (23.2-157.7)	57.4 (25.1-117.3)	93.2 (37.9-168.2)	0.03^a
Elevated CA19-9	114 (79.0)	56 (74.7)	85 (92.4)	0.04^a
CEA, median, IQR (ng/mL)	3.1 (1.3-5.5)	2.2 (0.9-5.3)	2.7 (1.4-5.7)	0.76
CA12-5, median, IQR (U/mL)	25.6 (11.3-87.5)	29.1(12.9-76.2)	27.2(14.6-86.9)	> 0.99
Direct bilirubin, median, IQR (μmol/L)	17.6 (6.3-86.1)	6.75 (3.9-91.8)	27.4 (5.6-107.3)	0.01^a
Indirect bilirubin, median, IQR (μmol/L)	5.3 (3.8-17.6)	3.6 (2.7-9.6)	7.50 (3.5-19.2)	0.02^a
Albumin, IQR (g/L)	41.5 ± 4.3	40.2 ± 7.6	39.5 ± 3.2	> 0.99
Serum glucose, median, IQR (mmol/L)	6.3 (4.5-10.9)	5.1 (4.9-8.2)	7.8 (5.3-13.2)	0.03^a
With abdominal CT or MRI	167 (100)	75 (100)	92 (100)	> 0.99
With ERCP	37 (34.1)	22 (29.3)	15 (16.3)	0.35
With EUS-FNA/B	105 (62.8)	64 (85.3)	41 (44.6)	0.02^a
Lymphatic metastasis	55 (33.0)	21 (28.0)	34 (37.0)	> 0.99
Liver metastasis	51 (30.5)	20 (26.7)	31 (33.7)	0.79
Tumor location (H/B/T)	150/9/8 (89.8/5.4/4.8)	68/5/2 (90.6/6.7/2.7)	82/4/6 (89.1/4.3/6.5)	0.35
With other causes				0.03^a
Gallstone obstruction	25 (15.0)	4 (5.3)	21 (22.8)
Heavy alcohol	8 (4.8)	2 (2.7)	6 (6.5)
Hyperlipidemia	13 (7.7)	1 (1.3)	12 (13.0)
None	121 (72.5)	68 (90.7)	53 (57.7)
With resectional surgery	61 (36.5)	34 (45.3)	27 (29.3)	< 0.01^a
With chemotherapy	113 (67.7)	42 (56.0)	71 (77.2)	0.03^a
Hospital stays, median IQR, (days)	11 (8-20.5)	10 (7.5-14.25)	17.1 (11.7-21.5)	< 0.01^a
Cost, median IQR, (Chinese yuan)	30241 (16722-66529)	18255 (15042-26263)	34889 (21074-61922)	< 0.01^a

^aP < 0.05.

IQR: Inter quartile range; CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; CT: Computed tomography; MRI: Magnetic resonance imaging; ERCP: Endoscopic retrograde cholangiopancreatography; EUS-FNA/B: Endoscopic ultrasound-guided fine needle aspiration/biopsy; H/B/T: Head/body/tail.

Table 3 Multivariate logistic regression of factors with early diagnosis of tumor-associated acute pancreatitis

	OR	95%CI	P value
Age	1.51	1.04-1.89	0.02^a
Alcohol history	1.26	0.29-5.96	0.74
Diabetes history	2.69	1.08-3.34	0.04^a
With other causes	4.77	1.84-7.81	0.02^a
CA19-9 levels	1.38	1.03-1.84	0.04^a
Direct bilirubin	2.36	1.35-3.48	0.03^a
Indirect bilirubin	2.67	1.38-4.62	0.03^a
Serum glucose	1.42	1.08-2.55	0.04^a

^aP < 0.05.

CA: Carbohydrate antigen; OR: Odds ratio; CI: Confidence interval.

Citation: Xia CC, Ning LG, Xu Y, Xu GQ. Clinical characteristics and diagnostic factors of tumor-associated acute pancreatitis: A comparative analysis of early vs delayed diagnosis. World J Gastrointest Oncol 2025; 17(8): 109743
URL: https://www.wjgnet.com/1948-5204/full/v17/i8/109743.htm
DOI: https://dx.doi.org/10.4251/wjgo.v17.i8.109743