Endoscopic Ultrasound-Guided Fine Needle Aspiration and Multidetector Spiral CT in the Diagnosis of Pancreatic Cancer

Agarwal, Banke; Abu-Hamda, Emad; Molke, Kimber L.; Correa, Arlene M.; Ho, Linus

doi:10.1111/j.1572-0241.2004.04177.x

Cited by 301 publications

(179 citation statements)

References 13 publications

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“…To overcome this difficulty, endoscopic ultrasonography-guided fine-needle aspiration biopsy (EUS-FNAB) is applied to obtain tumour cells as an effective and safe method for tissue diagnosis of pancreatic cancer (Agarwal et al, 2004). More recently, several investigators have demonstrated that genetic analysis using EUS-FNAB specimens is possible for determination of cancer stage or to improve the accuracy of diagnosis (Tada et al, 2002;Pellise et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Gemcitabine chemoresistance and molecular markers associated with gemcitabine transport and metabolism in human pancreatic cancer cells

et al. 2007

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To identify predictive molecular markers for gemcitabine resistance, we investigated changes in the expression of four genes associated with gemcitabine transport and metabolism during the development of acquired gemcitabine resistance of pancreatic cancer cell lines. The expression levels of human equilibrative nucleoside transporter-1 (hENT1), deoxycytidine kinase (dCK), RRM1, and RRM2 mRNA were analysed by real-time light cycler-PCR in various subclones during the development of acquired resistance to gemcitabine. Real-time light cycler-PCR demonstrated that the expression levels of either RRM1 or RRM2 progressively increased during the development of gemcitabine resistance. Expression of dCK was slightly increased in cells resistant to lower concentrations of gemcitabine, but was decreased below the undetectable level in higher concentration-resistant subclones. Expression of hENT1 was increased in the development of gemcitabine resistance. As acquired resistance to gemcitabine seems to correlate with the balance of these four factors, we calculated the ratio of hENT1 Â dCK/RRM1 Â RRM2 gene expression in gemcitabine-resistant subclones. The ratio of gene expression decreased progressively with development of acquired resistance in gemcitabine-resistant subclones. Furthermore, the expression ratio significantly correlated with gemcitabine sensitivity in eight pancreatic cancer cell lines, whereas no single gene expression level correlated with the sensitivity. These results suggest that the sensitivity of pancreatic cancer cells to gemcitabine is determined by the ratio of four factors involved in gemcitabine transport and metabolism. The ratio of the four gene expression levels correlates with acquired gemcitabine-resistance in pancreatic cancer cells, and may be useful as a predictive marker for the efficacy of gemcitabine therapy in pancreatic cancer patients.

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Section: Discussionmentioning

confidence: 99%

Gemcitabine chemoresistance and molecular markers associated with gemcitabine transport and metabolism in human pancreatic cancer cells

et al. 2007

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“…Higher sensitivities of tumor detection and size assessment with EUS have been reported [28][29][30]. The study by Tamm et.al.…”

Section: Ctmentioning

confidence: 92%

“…A few studies have compared CT to EUS in the detection and staging of pancreatic tumors [28][29][30][31]. Higher sensitivities of tumor detection and size assessment with EUS have been reported [28][29][30].…”

Section: Ctmentioning

confidence: 99%

Imaging in Staging and Management of Pancreatic Ductal Adenocarcinoma

Vikram

Balachandran

2010

Indian J Surg Oncol

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Pancreatic cancer is a relatively common malignancy of the gastrointestinal tract for which complete surgical excision remains the only curative option. Being infiltrative in nature and bearing a complex anatomical relationship with various organs, peritoneal ligaments and vascular structures, accurate anatomical staging is key in treatment of these patients. In this article, we will discuss and provide a brief overview of anatomy and use of imaging in staging pancreatic cancer.

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“…In addition, radiological finding of early pancreatic cancer is not adequate to support for performing major surgery like PD, particularly if patient is asymptomatic. 60,61 Gangi et al 59 described the presence of pancreatic ductal dilation without any identifiable mass several months before final diagnosis of pancreatic cancer. Endoscopic ultrasound-guided FNA (EUS-FNA) is believed to provide cytological diagnosis with specificity of around 100%.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic ultrasound-guided FNA (EUS-FNA) is believed to provide cytological diagnosis with specificity of around 100%. 24,60,62 Therefore, usage of EUS-FNA whenever necessary can achieve early diagnosis and can act as a sound basis for prompt treatment and definitive management of pancreatic cancer, including PD. Other factor that is regarded highly in terms of survival outcome is tumor resection margin.…”

Section: Discussionmentioning

confidence: 99%

Impact of tumor size on survival outcome of pancreatic carcinoma following pancreatic resection: A systematic review and meta-analysis

Shrestha

Baskota

et al. 2018

Asian J Med Sci

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A B S T R A C T REVIEW ARTICLE ASIAN JOURNAL OF MEDICAL SCIENCESThe aim of the study was to evaluate the influence of tumor size on long-term survival outcome of pancreatic tumors following pancreatic resection and the possibility of implementing another tumor size cut-off point in AJCC pancreatic tumor staging. Literature searches was conducted on electronic database to identify relevant studies on tumor size related survival outcome following pancreatic resection for pancreatic adenocarcinoma. Meta-analysis was done using the effect estimates and the use of 95% confidence intervals (CIs) was done to calculate the pooled risk estimates; heterogeneity among studies was examined using I 2 statistic. Total of 18 trials (13 retrospective and 5 prospective studies) including 6230 elderly patients was included in this study. The pooled HR of the tumor size with 2 cm cut-off was 1.43 with 95% CI of [1.27-1.62], I 2 = 17%, p<0.00001 and was statistically significant. Median survival for tumor size <2, >2, <3, >3, <4 and >4 were 41.02 months, 16.20 months, 19.41 months, 10.79 months, 24.2 months and 15.14 months respectively and the 1-, 3-, and 5-year survival rate decreased with increasing tumor diameter. Importantly, a total of four studies results indicated that 3-year survival rate and a total of five studies results indicated that 5-year survival rate had statistical significance with 3 cm cut-off. Tumor diameter of 2 cm seems to be a reasonable but relatively less comprehensive cut-off point. 3 cm cut-off maybe become a new potential tumor size cut-off point in addition to the current sole 2 cm cut-off point defining tumor stage.

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Endoscopic Ultrasound-Guided Fine Needle Aspiration and Multidetector Spiral CT in the Diagnosis of Pancreatic Cancer

Abstract: The EUS with FNA can be a valuable adjunct to newer high-resolution multidetector spiral CT for diagnostic evaluation of patients with suspected pancreatic cancer.

Cited by 301 publications

References 13 publications

Gemcitabine chemoresistance and molecular markers associated with gemcitabine transport and metabolism in human pancreatic cancer cells

Gemcitabine chemoresistance and molecular markers associated with gemcitabine transport and metabolism in human pancreatic cancer cells

Imaging in Staging and Management of Pancreatic Ductal Adenocarcinoma

Impact of tumor size on survival outcome of pancreatic carcinoma following pancreatic resection: A systematic review and meta-analysis

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