Pancreatic arteriography, transhepatic pancreatic venography, and pancreatic venous sampling in diagnosis of pancreatic cancer

Rösch, Josef; Keller, Frederick S.

doi:10.1002/1097-0142(19810315)47:6+<1679::aid-cncr2820471436>3.0.co;2-h

Cited by 12 publications

(3 citation statements)

References 10 publications

(2 reference statements)

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“…Early detection would improve the chance of curative surgery. If pancreatic disease were detected by a screening test, it might not be difficult to diagnose even small cancers by modern methods such as ERCP, PTC (Freeny & Ball, 1981), echography lishi et al, 1986), CT scan (Sakahara et al, 1986), angiography (Rosch & Keller, 1981), and other clinical and laboratory findings. Therefore, the most important and difficult problem is detection of pancreatic pathology in asymptomatic patients.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic value of the foetoacinar pancreatic (FAP) protein in cancer of the pancreas; a comparative study with CA19/9

Fujii

Albers²,

Carre-Llopis³

et al. 1987

Br J Cancer

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Summary The serum diagnostic value of the foeto-acinar pancreatic protein (FAP protein), an oncofoetal pancreatic antigen, was tested in 201 patients. Of these, 112 suffered from malignant disease (57 patients had pancreatic carcinoma and 55, extra-pancreatic malignancies) and 89 had benign disease (49 patients with hepato-pancreato-biliary disease and 40 with other benign disease). FAP protein was measured by a competitive radioimmunoassay. In this technique, the normal cut-off level was 10% inhibition. This was deducted from values in 32 normal sera. FAP protein levels superior to 10% inhibition were found in 86% of patients with pancreatic cancer, in 31% with non-pancreatic malignancy, in 69% with benign hepatopancreato-biliary disease and in 20% with other benign diseases. Accordingly, sensitivity of FAP protein for pancreatic carcinoma was 86% and specificity, 66%. However, high FAP protein levels (>30% inhibition) were almost exclusively seen in patients with pancreatic cancer. At this cut-off level, specificity increased to 95% but sensitivity decreased to 51%. Determination of the carbohydrate antigen CA19/9 was made in parallel by a commercially available assay. At the cut-off level of 37uml-1, CAl9/9 in our serum panel had a sensitivity of 74% for pancreatic carcinoma and a specificity of 88%. In pancreatic cancer 55 out of 57 patients had elevated levels of either FAP protein or CA19/9 (sensitivity; 96%).

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Section: Discussionmentioning

confidence: 99%

The diagnostic value of the foetoacinar pancreatic (FAP) protein in cancer of the pancreas; a comparative study with CA19/9

Fujii

Albers²,

Carre-Llopis³

et al. 1987

Br J Cancer

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“…small pancreatic tumors and to differentiate pancreatic lesions [36]. It also gives information about vascular abnormalities which the surgeon should be aware of, such as an aberrant hepatic artery and regional hypertension.…”

Section: Percutaneous Transhepatic Cholangiographymentioning

confidence: 99%

“…Above all, the arteriogram, especially if followed up by a study of the venous phase, is of crucial value regarding the appraisal of resectability. Involvement of peripancreatic vessels, especially large vessels like the celiac, hepatic, or superior mesenteric artery, or the portal, splenic, or superior mesenteric vein indicates unresectable tumor [36]. A better visualization of the veins is given by the percutaneous transhepatic portogram, which may be used as a complement to the arteriogram, if the latter does not give unequivocal results [37].…”

Section: Percutaneous Transhepatic Cholangiographymentioning

confidence: 99%

Preoperative and operative diagnosis of pancreatic cancer

Ihse

Isaksson

1984

World j. surg.

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The aim of the investigation in the case of pancreatic cancer is to establish the diagnosis and to evaluate resectability. Improved diagnostic methods have made it possible in most cases to diagnose accurately the symptomatic patient with pancreatic cancer. Ultrasonography, computed tomography, endoscopic retrograde cholangiopancreatography (ERCP), and cytology are methods that often complement each other in the diagnostic workup. Percutaneous transhepatic cholangiography (PTC) is useful in the jaundiced patient, but is not as safe for the patient as ERCP. For patients in whom resection is contemplated, angiography is also of interest, as signs of major vessel involvement contraindicate surgery. Pancreatic function tests, tumor markers, and scintigraphy do not contribute enough to be used as diagnostic aids, and laparoscopy is only rarely indicated. At operation the final assessment of resectability is determined by documentation of spread to lymph nodes or to other organs and the invasion of neighboring vessels.

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Operative approach to cancer of the head of the pancreas and the peri-ampullary region

Obertop

Bruining

Schattenkerk

et al. 1982

Journal of British Surgery

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A retrospective study was made of 75 consecutive patients treated for a tumour of the head of the pancreas and the peri-ampullary region from January 1978 to August 1981. These patients underwent either pancreatic resection--pancreatoduodenectomy (n = 24) and total pancreatectomy (n = 10)--palliative procedures (n = 29) or exploratory laparotomy (n = 12). Clinical signs and diagnostic procedures, such as ultrasonography and coeliac arteriography, were studied for their value in preoperative assessment of operability. Vaso-invasion, as revealed by arteriography and, to a lesser extent, ultrasonographic signs of a tumour and the absence of jaundice were poor prognostic signs. The operative mortality was 8 per cent for the group as a whole, but somewhat higher (13 per cent) for the group that underwent pancreatoduodenectomy. No patient died after total pancreatectomy. The operative mortality was 27 per cent in all patients aged 70 years or older, but only 3 per cent in patients under 70 years. One-year patient survival was 94 per cent after pancreatoduodenectomy for peri-ampullary cancer and 57 per cent after resection for cancer of the head of the pancreas. The results of this study point to pancreatic resection as the treatment of choice for resectable tumours of the peri-ampullary region and the head of the pancreas in patients under 70 years of age. Coeliac arteriography and ultrasonography have been found to be useful for preoperative classification of tumour stage.

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Pancreatic arteriography, transhepatic pancreatic venography, and pancreatic venous sampling in diagnosis of pancreatic cancer

Cited by 12 publications

References 10 publications

The diagnostic value of the foetoacinar pancreatic (FAP) protein in cancer of the pancreas; a comparative study with CA19/9

The diagnostic value of the foetoacinar pancreatic (FAP) protein in cancer of the pancreas; a comparative study with CA19/9

Preoperative and operative diagnosis of pancreatic cancer

Operative approach to cancer of the head of the pancreas and the peri-ampullary region

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