Exploring and validating the clinical risk factors for pancreatic cancer in chronic pancreatitis patients using electronic medical records datasets: three cohorts comprising 2,960 patients

Xin Zhao, Ren Lang, Zhigang Zhang, Weiling Zhao, Zhiwei Ji, Hua Tan, Xiaobo Zhou

Abstract

Background: Patients with chronic pancreatitis (CP) have an increased risk of developing pancreatic cancer (PC). The purpose of this study was to identify predictors of PC in CP patients.
Methods: Electronic medical records (EMRs) of CP patients from two cohorts were collected, and a logistic regression analysis was performed to investigate the risk factors for PC. Subsequently, we validated the value of the risk prediction model with the EMRs of a third cohort.
Results: The derivation cohort consisted of 2,545 CP patients, and among them, 14 patients developed PC 7 years after CP diagnosis. Cyst of the pancreas [COP; odds ratio (OR): 4.37, 95% confidence interval (CI): 1.11 to 18.40, P=0.033], loss of weight (LW; OR: 3.21, 95% CI: 0.76 to 12.91, P=0.096) and high platelet (PLT) count (OR: 1.01 per 1 increment, 95% CI: 1.00 to 1.01, P=0.042) were independent risk factors for PC among CP patients. A risk prediction equation was constructed as follows: ln[p/(1–p)] = –6.68 + 1.55COP + 1.23LW + 0.0046PLT. The areas under the receiver operating characteristic (ROC) curve of our risk score were 0.83 and 0.72 in the derivation and validation cohorts, respectively. A score >0.0128 and >0.0122 had the best balance between sensitivity and specificity in the derivation and validation cohorts, respectively.
Conclusions: In CP patients, LW, COP and high PLT count were identified as novel predictors of PC. A risk prediction model based on these factors exhibited moderate predictive value for CP patients.