Diagnostic Yield of Serial Pancreatic Juice Aspiration Cytologic Examination With Brush Cytology for Pancreatic Ductal Stenosis

Mie, Takafumi; Sasaki, Takashi; Takeda, Tsuyoshi; Okamoto, Takeshi; Mori, Chinatsu; Furukawa, Takaaki; Yamada, Yuto; Kasuga, Akiyoshi; Ozaka, Masato; Sasahira, Naoki

doi:10.1097/mpa.0000000000002135

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…Yamaguchi et al [ 31 ] reported that brush cytology combined with PJC after brushing significantly increased the diagnostic sensitivity of PDAC. In contrast, Mie et al [ 32 ] retrospectively examined 34 patients who underwent SPACE with brush cytology for pancreatic duct stenosis and reported that the efficacy of adding brush cytology to SPACE was limited. Further prospective studies are required to clarify the effect of brush cytology on the diagnostic yield of PDAC after repeated PJC using an ENPD catheter.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Ability and Safety of Repeated Pancreatic Juice Cytology Using an Endoscopic Nasopancreatic Drainage Catheter for Pancreatic Ductal Adenocarcinoma: A Multicenter Prospective Study

Nakamura,

Ishii,

Serikawa

et al. 2023

Diagnostics

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Pathological examination is essential for the diagnosis and treatment of pancreatic ductal adenocarcinoma (PDAC). Moreover, a reliable pathological diagnosis is extremely important for improving prognosis, especially in early-stage PDAC. This study prospectively evaluated the usefulness of repeated pancreatic juice cytology (PJC) using an endoscopic nasopancreatic drainage (ENPD) catheter for the diagnosis of PDAC. We enrolled 82 patients suspected of having resectable PDAC, based on imaging studies, and judged the necessity for cytology. The diagnostic yield of up to six repeated PJCs and the incidence of complications, such as pancreatitis, was evaluated. A total of 60 patients were diagnosed with PDAC. The overall sensitivity and specificity were 46.7% and 95.5%, respectively. The cumulative positivity rate increased with the number of sampling sessions, reaching 58.3% in the sixth session. The sensitivity was significantly higher in the pancreatic head than in the pancreatic tail (p = 0.043). Additionally, it was 100% in four patients with a tumor size ≤10 mm. Pancreatitis occurred in six patients (7.3%), all of whom were treated conservatively. In the diagnosis of PDAC, repeated PJC using an ENPD catheter revealed a cumulative effect of sensitivity up to six times and an excellent diagnostic yield for small PDAC.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Ability and Safety of Repeated Pancreatic Juice Cytology Using an Endoscopic Nasopancreatic Drainage Catheter for Pancreatic Ductal Adenocarcinoma: A Multicenter Prospective Study

Nakamura,

Ishii,

Serikawa

et al. 2023

Diagnostics

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“…Factors that influenced the positive diagnosis were examined, but no significant differences in gender, age, location, or tumor diameter were observed. Mie et al aimed to improve diagnostic performance by combining SPACE with brush cytology, but its effectiveness was limited [26]. Although SPACE and S-PJC have improved diagnostic performance compared to single PJC, no studies have compared the diagnostic performance between the two techniques.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Juice Cytology Evaluations Using Synthetic Secretin and Serial Pancreatic Juice Aspiration Cytological Examination for the Diagnosis of Pancreatic Ductal Adenocarcinoma

et al. 2023

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Pathological examination by endoscopic ultrasound–fine needle aspiration is not possible in approximately 10% of pancreatic tumor cases. Pancreatic juice cytology (PJC) is considered an alternative diagnostic method. However, its diagnostic capability is insufficient, and PJC has been repeatedly redevised. Serial pancreatic juice aspiration cytological examination (SPACE) and secretin-loaded PJC (S-PJC) have been recently introduced as alternative diagnostic methods. This study aimed to determine the diagnostic capacity and safety of SPACE and S-PJC using a propensity score-matched analysis. The sensitivity, specificity, and accuracy were 75.0%, 100%, and 92.3% for S-PJC, respectively, and 71.4%, 100%, and 92.3% for SPACE, respectively, meaning that there was no significant difference between the groups. Four patients (15.4%) each in the S-PJC and SPACE groups experienced complications, including postendoscopic retrograde cholangiopancreatography, pancreatitis, and cholangitis. Overall, there was no difference in efficacy and safety between the SPACE and S-PJC groups.

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Current status of molecular diagnostic approaches using liquid biopsy

et al. 2023

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Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and lethal cancers, and developing an efficient and reliable approach for its early-stage diagnosis is urgently needed. Precancerous lesions of PDAC, such as pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasms (IPMN), arise through multiple steps of driver gene alterations in KRAS, TP53, CDKN2A, SMAD4, or GNAS. Hallmark mutations play a role in tumor initiation and progression, and their detection in bodily fluids is crucial for diagnosis. Recently, liquid biopsy has gained attention as an approach to complement pathological diagnosis, and in addition to mutation signatures in cell-free DNA, cell-free RNA, and extracellular vesicles have been investigated as potential diagnostic and prognostic markers. Integrating such molecular information to revise the diagnostic criteria for pancreatic cancer can enable a better understanding of the pathogenesis underlying inter-patient heterogeneity, such as sensitivity to chemotherapy and disease outcomes. This review discusses the current diagnostic approaches and clinical applications of genetic analysis in pancreatic cancer and diagnostic attempts by liquid biopsy and molecular analyses using pancreatic juice, duodenal fluid, and blood samples. Emerging knowledge in the rapidly advancing liquid biopsy field is promising for molecular profiling and diagnosing pancreatic diseases with significant diversity.

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Diagnostic Yield of Serial Pancreatic Juice Aspiration Cytologic Examination With Brush Cytology for Pancreatic Ductal Stenosis

Cited by 4 publications

References 23 publications

Diagnostic Ability and Safety of Repeated Pancreatic Juice Cytology Using an Endoscopic Nasopancreatic Drainage Catheter for Pancreatic Ductal Adenocarcinoma: A Multicenter Prospective Study

Diagnostic Ability and Safety of Repeated Pancreatic Juice Cytology Using an Endoscopic Nasopancreatic Drainage Catheter for Pancreatic Ductal Adenocarcinoma: A Multicenter Prospective Study

Pancreatic Juice Cytology Evaluations Using Synthetic Secretin and Serial Pancreatic Juice Aspiration Cytological Examination for the Diagnosis of Pancreatic Ductal Adenocarcinoma

Current status of molecular diagnostic approaches using liquid biopsy

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