High Score of ELST-Blue in Endoscopic Ultrasonography Strain Elastography May Provide a High Risk Group of Early Chronic Pancreatitis with the Reduction of Apolipoprotein A2-i Index.

Background: To evaluate the usefulness of the ELST-blue score to explore its potential application in identifying high-risk groups for early chronic pancreatitis (ECP) through reflecting on pancreatic elasticity and the reduction of pancreatic function, and we tried to demonstrate whether the ELST-blue score was significantly associated with apolipoprotein A2 (apoA2) isoforms in patients with ECP.

Methods: Forty-four patients with pancreatic enzyme abnormalities underwent endosonography. We divided two groups, one group was patients with ECP ( = 16) and the other group was patients with non-ECP ( = 28). ELST-blue was defined using the open-source software 'Image J'. The concentration of apoA2 isoforms was measured using an enzyme-linked immunosorbent assay kit.

Results: Epigastric pain tended to be more severe in patients with ECP than in those without ECP. There was a significant difference in the diameter of the main pancreatic duct of more than 2 mm as well as in stranding or hyperechoic foci and lobularity between patients with ECP and non-ECP. The ELST-blue score was significantly higher in patients with ECP than in non-ECP ( = 0.003). Although an intense negative correlation was determined between ELST-blue score and the apoA2-i Index in patients with ECP (r = -0.704, = 0.002), there was no significant relationship between ELST-blue score and apoA2-I Index in patients with non-ECP.

Conclusions: Patients with ECP accompanied by a high score of ELST-blue have to be followed up carefully.