Roles of ERCP in the Early Diagnosis of Pancreatic Cancer

Hanada, Keiji; Minami, Tomoyuki; Shimizu, Akinori; Fukuhara, Motomitsu; Yano, Shigeki; Sasaki, Kenji; Koda, Masanori; Sugiyama, Kayo; Yonehara, Shuji; Yanagisawa, Akio

doi:10.3390/diagnostics9010030

Cited by 29 publications

(26 citation statements)

References 33 publications

(47 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of these, 78% of patients were detected with indirect imaging findings. Hanada et al established a social diagnostic project on early-stage PDAC [ 15 , 16 ]. Doctors specialized in PDAC have recommended general practitioners to perform US for patients exhibiting the risk factors of PDAC.…”

Section: Discussionmentioning

confidence: 99%

Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study

et al. 2021

Self Cite

View full text Add to dashboard Cite

Early diagnosis of pancreatic ductal adenocarcinoma (PDAC) is challenging but essential for improving its poor prognosis. We established a multicenter study to clarify the clinicopathological features, and to propose new algorithm for early diagnosis of PDAC. Ninety-six patients with stage 0 and IA PDAC were enrolled from 13 high-volume centers. Overall, 70% of the patients were asymptomatic. The serum pancreatic enzyme levels were abnormal in half of the patients. The sensitivity of endoscopic ultrasonography (EUS) for detecting small PDAC was superior to computed tomography and magnetic resonance imaging (MRI) (82%, 58%, and 38%, respectively). Indirect imaging findings were useful to detect early-stage PDAC; especially, main pancreatic duct stenosis on MRI had the highest positive rate of 86% in stage 0 patients. For preoperative pathological diagnosis, the sensitivity of endoscopic retrograde cholangiopancreatography (ERCP)-associated pancreatic juice cytology was 84%. Among the stage IA patients, EUS-guided fine-needle aspiration revealed adenocarcinoma in 93% patients. For early diagnosis of PDAC, it is essential to identify asymptomatic patients and ensure close examinations of indirect imaging findings and standardization of preoperative pathological diagnosis. Therefore, a new diagnostic algorithm based on tumor size and imaging findings should be developed.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…On reviewing our presurgical examinations, we obtained diagnostic clues concerning type 1 AIP. First, we were able to reexamine ERP for the pancreatic juice cytology by placing endoscopic naso-pancreatic duct drainage ( 16 , 17 ) and for a transpapillary biopsy from the stenotic site of the MPD. The risk associated with a pancreatic duct biopsy is thought to be low in cases with an atrophic upstream pancreas ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Type 1 Autoimmune Pancreatitis Extending along the Main Pancreatic Duct: IgG4-related Pancreatic Periductitis

et al. 2021

View full text Add to dashboard Cite

We herein report a unique form of autoimmune pancreatitis (AIP) spreading along the main pancreatic duct (MPD). A 70-year-old man was referred for a small lesion at the pancreatic neck, accompanying an adjacent cyst and dilated upstream MPD. Four years earlier, health checkup images had shown a pancreatic cyst but no mass lesion. Endoscopic ultrasonography showed a contrast-enhanced, tumorous lesion, mainly occupying the MPD. With a preoperative diagnosis of ductal neoplasms mainly spreading in the MPD, Whipple's resection was performed. The resected specimens showed MPD periductitis with IgG4-related pathology, indicating type 1 AIP. Clinicians should practice caution concerning the various AIP forms.

show abstract

“…These results suggest that EUS–FNA is useful for diagnosing small PCs; however, it cannot be used for pancreatic cancers that do not have sufficient mass lesions, including PCIS. In such cases, ERCP-based pancreatic juice cytology may be helpful for pathological diagnosis [ 24 , 25 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Ultrasonography Diagnosis of Early Pancreatic Cancer

2020

Self Cite

View full text Add to dashboard Cite

Early diagnosis of pancreatic cancer (PC) can improve patients’ prognosis. We aimed to investigate the utility of endoscopic ultrasonography (EUS) for the early diagnosis of PC. This study included 64 patients with PC at an early stage treated at Onomichi General Hospital between January 2007 and January 2020. Diagnostic procedures included contrast computed tomography (CT), magnetic resonance cholangiopancreatography, EUS fine-needle aspiration, and endoscopic retrograde cholangiopancreatography (ERCP) for pancreatic juice cytology. The mean age was 71.3 years. In all, 32 patients were stage 0, and 32 were stage I. As for image findings, the main pancreatic duct (MPD) stenosis was detected in several cases, although CT and MRCP seldom detected tumors. EUS had a high detection rate for stage 0 tumor lesions. The median observation period was 3.9 years. In cases with stage 0, the 1 year and 5 year survival rates were 100% and 78.9%, respectively. In cases with stage I, the 1 year and 5 year survival rates were 96.4% and 66.7%, respectively. EUS has the highest sensitivity among all imaging modalities for detecting small pancreatic tumors. Cases with MPD dilation or stenosis, especially with tumors that cannot be identified on CT and MRI, should have EUS performed. In some cases, EUS was not able to detect any tumor lesions, and ERCP-based pancreatic juice cytology should be useful for pathological diagnosis.

show abstract

Roles of ERCP in the Early Diagnosis of Pancreatic Cancer

Cited by 29 publications

References 33 publications

Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study

Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study

Type 1 Autoimmune Pancreatitis Extending along the Main Pancreatic Duct: IgG4-related Pancreatic Periductitis

Endoscopic Ultrasonography Diagnosis of Early Pancreatic Cancer

Contact Info

Product

Resources

About