title: Endoscopic ultrasonography and alcoholic patients: can one predict early pancreatic tissue abnormalities?
abstract: BACKGROUND
  The diagnosis of chronic pancreatitis in early stages remains challenging and agreement between various methods is poor. Alcohol consumption is the most important cause of chronic pancreatitis.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the endosonographic evidence of pancreatic disease in patients with alcohol abuse.
  
  
  METHODS
  Consecutive patients referred for endoscopic ultrasonography for various indications between May 2001 and December 2003.
  
  
  METHODS
  Two hundred twenty-eight patients were enrolled in the study. One hundred 89 patients were studied; 39 (17.1%) were excluded because the pancreas could not be completely assessed (n=23) or because a previous diagnosis of chronic pancreatitis and/or pancreatic neoplasm was suspected (n=16).
  
  
  METHODS
  Prospective study. The patients were divided into 2 groups: alcoholics (n=17) and non-alcoholics (n=172).
  
  
  METHODS
  The assessment of pancreatic disease according to parenchymal and ductal changes as previously described by Catalano and Sahai (scores 1 and 2, respectively).
  
  
  RESULTS
  The male:female ratio was 7.5 and 0.9 in the alcoholic and the non-alcoholic groups, respectively (P=0.002). Mean ages were 53.0 and 47.8 years, respectively (P=0.156). Alcoholic patients had significantly (P<0.001) more endosonographic abnormalities than non-alcoholics for both scores. A ROC curve comparison between patients and controls showed that the best specificity and sensitivity combination was obtained for the number of EUS features greater than 1 and 2 for the scores 1 and 2, respectively.
  
  
  CONCLUSIONS
  Alcoholic patients had significantly more endosonographic abnormalities reflecting possible early changes of chronic pancreatitis. By using reported scores, values up to 1 or 2 can be seen in patients with no risk for pancreatitis, suggesting that chronic pancreatitis should be considered only for scores equal to or greater than 2 or 3 for scores 1 and 2, respectively.
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Fernanda Prata Borges Martins
authors.initials: FP
authors.lastname: Thuler
authors.forename: Patrícia Piauilino da
authors.initials: PP
authors.lastname: Costa
authors.forename: Gustavo Andrade de
authors.initials: GA
authors.lastname: Paulo
authors.forename: Frank Shigueo
authors.initials: FS
authors.lastname: Nakao
authors.forename: José Celso
authors.initials: JC
authors.lastname: Ardengh
authors.forename: Angelo Paulo
authors.initials: AP
authors.lastname: Ferrari
mesh_terms: D000437:Alcoholism / Q000150:complications*; D015415:Biomarkers / Q000097:blood; D002374:Catalase / Q000097:blood; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002908:Chronic Disease; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000000981:diagnostic imaging* / Q000209:etiology; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D002374:Catalase