Effectiveness of the cytologic examination of pure pancreatic juice in the diagnosis of early neoplasia of the pancreas

Abstract

Background. The early diagnosis of pancreatic carcinoma through the use of traditional radiographic or ultrasonographic methods is extremely difficult. Methods. To detect an early and potentially curable cancer of the pancreas, endoscopic retrograde pancreatography (ERP) and aspiration cytology of pure pancreatic juice were performed in 295 consecutive patients who had symptoms or findings that suggested pancreatic disease but in whom there was neither a pancreatic mass nor ductal stenosis. Results. Positive cytologic results were obtained in 12 patients (4%). With the aid of intraoperative cytodiagnosis, all 12 early neoplasms of the pancreas were successfully resected. Of these 12 resected specimens, 4 were adenocarcinoma with minimal invasion, 3 were in situ adenocarcinoma and 5 were marked atypia. All 12 patients were alive with no evidence of recurrence for an average of 32 months after surgery. The 283 patients who had negative ERP‐cytology results were observed, but no further cases of pancreatic cancer were found. Conclusions. Because ERP‐cytology is simple to perform, safe, and reliable, it is useful in the diagnosis of patients who have early neoplasm of the pancreas.

Staging and treatment for patients with pancreatic cancer. How small is an early pancreatic cancer?

“…Four papers30, reported in situ adenocarcinoma of the pancreas and intraductal carcinoma of the pancreas with minimal pancreatic parenchymal invasion regardless of tumor size. Mucin‐producing pancreatic cancers with marked dilatation of the main pancreatic duct or multicystic dilatation of the branch pancreatic duct,41 and cystadenocarcinomas42 were excluded from this study.…”

Diagnosis of Pancreatic Cancer by Detecting Telomerase Activity in Pancreatic Juice: Comparison With K- Ras Mutations

“…To detect pancreatic cancer at an early stage, it is essential to perform examinations of the pancreatic juice from patients who have abnormal pancreatograms shown by endoscopic retrograde pancreatography (ERP), even if no tumor image is shown by ultrasonography (US), endoscopic ultrasonography (EUS), or computed tomography (CT) (4). Pancreatic juice cytology is a reliable method for the diagnosis of pancreatic cancer (5,6), but its diagnostic rates are not always satisfactory (7)(8)(9)(10)(11).…”

Methylation status of p14ARF and p16INK4a as detected in pancreatic secretions

“…Retrograde pancreatography by a duodenoscope for the first time offered the opportunity to obtain directly ductal juice and to achieve tissue diagnosis in pancreatic disease in a minimal invasive manner (Endo et al, 1974;Hatfield et al, 1976). A multitude of studies have demonstrated that the joint application of endoscopy and cytotechniques has the capability to contribute to an improved clinical management (Tatsuta et al, 1983;Venu et al, 1990;Ryan, 1991;Nakaizumi et al, 1995;Enayati et al, 1996). However, while being characterised by a near 100% specificity, the sensitivity of pancreatic juice cytology proved to be unsatisfying because of an often low cell count or cell disintegration (Ferrari et al, 1994).…”