Journal Article

Advancing the Diagnosis and Treatment of Early Chronic Pancreatitis Through Innovation in Imaging and Biomarker Profiling—A Narrative Review

Mihai, Catalina, Petrea, Oana, Gheorghe, Liliana, Simiras, Constantin, Nemteanu, Roxana, Floria, Diana Elena, Barboi, Oana-Bogdana, Vulpoi, Radu Alexandru, Coseru, Alexandru-Ionut, Rosca, Vadim, Gîlca-Blanariu, Georgiana-Emanuela, Ciortescu, Irina, Sfarti, Catalin, Plesa, Alina, Drug, Vasile-Liviu, Balan, Gheorghe G.

2025

Overview

Early chronic pancreatitis (ECP) represents a potentially reversible stage in the natural history of chronic pancreatic disease. Timely diagnosis of ECP offers a possibility for intervention, yet its diagnosis remains challenging due to nonspecific symptoms, lack of standardized criteria, and the limited diagnostic sensitivity of conventional tools. This review aims to synthesize recent advancements in the understanding, detection, and management of ECP, with a focus on innovation in imaging techniques and biomarker profiling. The goal is to facilitate earlier diagnosis and more effective patient stratification. We reviewed the literature from the past five years, including original studies, meta-analyses, and expert consensus statements, to address the current evidence across genetic, inflammatory, imaging, and biochemical domains relevant to ECP. Endoscopic ultrasound and advanced magnetic resonance techniques offer high sensitivity in detecting early parenchymal changes, although inter-observer variability and lack of standardization persist. Biomarker discovery has focused on inflammatory (IL-6, sCD163), fibrotic (TGF-β1, TIMP-1), and oxidative markers, as well as novel candidates like microRNAs. Genetic predisposition (PRSS1, SPINK1, CTRC, CPA1, CLDN2) significantly influences disease onset and progression and could enable selection of high-risk individuals. Therefore, diagnosing ECP should involve a multidisciplinary precision-based approach integrating clinical, radiologic, molecular, serologic, and genetic data for individualized risk stratification.

• Publisher: MDPI AG,Multidisciplinary Digital Publishing Institute (MDPI)
• Subject: Alcohol / Biological markers / Biomarkers / Care and treatment / Chronic illnesses / chronic pancreatitis / Cysts / Diagnosis / Diagnostic imaging / early chronic pancreatitis / endoscopic ultrasound / Enzymes / Health aspects / Imaging techniques / Inflammation / Innovations / Lifestyles / Magnetic resonance / Magnetic resonance imaging / Medical imaging / miRNA / Morphology / Pancreatic diseases / Pancreatitis / Population-based studies / recurrent acute pancreatitis / Review / Sensitivity / Standardization / Surveillance / therapeutic endoscopy / Tissue inhibitor of metalloproteinase 1 / Transforming growth factor-b1 / Ultrasonic imaging