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World J Gastrointest Oncol. Nov 15, 2026; 18(11): 123688
Published online Nov 15, 2026. doi: 10.4251/wjgo.123688
Published online Nov 15, 2026. doi: 10.4251/wjgo.123688
Occult pancreatic ductal adenocarcinoma in patients undergoing invasive evaluation for chronic pancreatitis: A retrospective study
Wan-Zhen Wei, Kong-Yuan Wei, Xue Yang, Liang Han, Zheng Wang, Wan-Xing Duan, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Wan-Zhen Wei, Kong-Yuan Wei, Xue Yang, Liang Han, Zheng Wang, Wan-Xing Duan, Pancreatic Disease Center, Xi'an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Hai-Rong He, Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Hao-Ze Leng, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Yi-Na Jiang, Department of Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Jing Xue, Shanghai Cancer Institute, Renji Hospital, Shanghai 200127, Shanghai, China
Co-corresponding authors: Zheng Wang and Wan-Xing Duan.
Author contributions: Wei WZ analyzed the data and drafted the original manuscript; Leng HZ collected the clinical data of the patients; He HR conducted the statistical analysis and interpreted the data; Jiang YN performed the pathological review; Wei KY, Yang X, Han L, and Xue J critically revised the manuscript for important intellectual content; all authors critically reviewed the manuscript, approved the final version for publication, and were responsible for the decision to submit the manuscript for publication; and Wang Z and Duan WX contributed equally to this work as co-corresponding authors, with equal responsibilities in obtainment of funding and contributions to the study conception and design, data analysis and interpretation, manuscript revision, and final approval of the version to be published.
AI contribution statement: AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Supported by National Natural Science Foundation of China, No. 82372895 and No. 82172853; the Key Research and Development Program of Shaanxi, No. 2024SF2-GJHX-03; the Natural Science Foundation of Shaanxi Province, No. 2023-JC-ZD-54; and the Innovative Team Foundation of Shaanxi Health Commission, No. 2024TD-16.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Xi'an Jiaotong University (No. XJTU1AF2024 LSYY-446).
Informed consent statement: The need for patient consent was waived owing to the retrospective nature of the study.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Corresponding author: Wan-Xing Duan, MD, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi’an 710061, Shaanxi Province, China. 15339184808@163.com
Received: May 27, 2026
Revised: July 17, 2026
Accepted: August 28, 2026
Published online: November 15, 2026
Processing time: 154 Days and 13.5 Hours
Revised: July 17, 2026
Accepted: August 28, 2026
Published online: November 15, 2026
Processing time: 154 Days and 13.5 Hours
Core Tip
Core Tip: Chronic pancreatitis (CP) is a well-established risk factor for pancreatic ductal adenocarcinoma (PDAC), yet distinguishing between the two conditions remains clinically challenging. In this study, 9.2% of 359 patients with CP who underwent invasive procedures were histopathologically diagnosed with occult PDAC. Elevated serum ionized calcium, carbohydrate antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA) levels were identified as independent predictors of occult malignancy, with dual markers of CA19-9 and CEA showing particular diagnostic value. Patients with CP are at risk of missed PDAC diagnosis. Our study identified readily available biomarkers to guide the detection of PDAC in this high-risk population.