The Role of Endoscopic Ultrasonography in the Diagnosis and Staging of Pancreatic Cancer

Zakaria, Ali; Al-Share, Bayan; Klapman, Jason; Dam, Aamir

doi:10.3390/cancers14061373

Cited by 15 publications

(14 citation statements)

References 191 publications

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“…EUS‐FNAC is a key procedure in the diagnosis and staging of PACs 9,10 which are tumours with poor prognosis 1,3 . A steady rise in their global incidence and prevalence has been noted over the last 25 years 1 .…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNAC) is a key component of the multimodal approach to the diagnosis and staging of pancreatic malignancies. [9][10][11] The Papanicolaou Society of Cytopathology (PSC) System for reporting Pancreaticobiliary Cytopathology (TPSCRPBC) provides a system of standardized nomenclature that facilitates and streamlines the communication of cytopathology reports. [11][12][13] TPSCRBC categorizes pancreaticobiliary lesions into six categories.…”

Section: Introductionmentioning

confidence: 99%

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Grading pancreatic adenocarcinomas on fine needle aspiration cytology. The outstanding issues

Mallik,

Qadan,

Mohanty

et al. 2023

Cytopathology

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ObjectiveThe three‐tier grading scheme described in “The Papanicolaou Society of Cytopathology (PSC) System for reporting Pancreaticobiliary Cytopathology” (TPSCRPBC) which remained unchanged following the WHO Reporting System for Pancreaticobiliary Cytopathology (WRPBC) was evaluated on pancreatic adenocarcinomas (PACs) reported on endoscopic ultrasound‐guided fine needle aspiration cytology (EUS‐FNAC).MethodsThe Papanicolaou and May Grunwald Giemsa‐stained smears from 116 cases of PACs were graded using the three‐tier grading scheme laid down by TPSCRPBC/WRPBC. Cases exhibiting multiple grades were assigned primary, secondary and tertiary grades. Each case was assigned a grade score, either by adding the primary and secondary grades, by adding the primary and tertiary grades when the tertiary grade was 3 or by doubling the grade when only one grade existed. Necrosis was estimated semi‐quantitatively. The inter‐observer reproducibility in grading was evaluated using Kappa and Kendall's tau‐c. Correlations between the various grades, the stage of the tumour and the amount of necrosis were assessed using Spearman rho and Kendall's tau‐b.Results31.89% of cases showed one grade, and 68.11% showed at least two grades. 16.38% showed three grades. The two commonest grade scores were 3 and 5. The inter‐observer reproducibility for grading and grade scoring was satisfactory. A positive correlation was noted between the grades and the amount of necrosis. No significant correlation was found between the grades, grade scores and the stage of the tumours.ConclusionsThe TPSCRPBC/WRPBC grading scheme can be suitably applied to PACs with good inter‐observer reproducibility. Cases often show multiple grades in the same tumour.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Grading pancreatic adenocarcinomas on fine needle aspiration cytology. The outstanding issues

Mallik,

Qadan,

Mohanty

et al. 2023

Cytopathology

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“…The incidence of PDAC is constantly increasing [ 6 ], and the median age of diagnosis is 66 years [ 12 ]. According to the National Comprehensive Cancer Network (NCCN), the most important risk factors for developing a PDAC are smoking, obesity, alcohol abuse, diabetes mellitus, chronic pancreatitis, and pancreatic neoplastic cystic lesions, such as intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasia (MCN) [ 13 , 14 ]. Chronic pancreatitis and neoplastic cystic lesions, as well as pancreatic intraepithelial neoplasia (PanIN), are considered precursor lesions for pancreatic cancer [ 15 , 16 ], and they are often detected simultaneously with primary tumors [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Synchronous Pancreatic Ductal Adenocarcinoma in the Head and Tail, a Double Trouble: A Case Report and Literature Review

Paramythiotis

Mavropoulou²,

Karlafti³

et al. 2022

Diagnostics

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Synchronous primary pancreatic ductal adenocarcinoma (PDAC) is very rare and can be formed either through multicentric carcinogenesis or intrapancreatic metastasis. We report the case of an 80-year-old man with a history of type 2 diabetes mellitus who presented with abdominal pain and weight loss. Laboratory tests showed elevated levels of blood glucose and CA 19-9, and Computed Tomography revealed two hypoenhancing lesions in the head and tail of the pancreas. Endoscopic ultrasound, which is the imaging method of choice for pancreatic cancer, was performed with a fine needle biopsy, and the cytological analysis diagnosed PDAC in both lesions. The patient underwent total pancreatectomy, and pathologic evaluation revealed synchronous primary PDAC with moderate to poor differentiation in the head and tail in the setting of IPMN (intraductal papillary mucinous neoplasia) and chronic pancreatitis. After his recovery from postoperative pulmonary embolism, the patient was discharged home with sufficient glycemic control. Multifocal PDAC occurs more often when precursor lesions, such as IPMN, pre-exist. The optimal treatment for multiple lesions spread all over the pancreas is total pancreatectomy. Diabetes mellitus is a serious complication of total pancreatectomy (new-onset or type 3c), but overall, long-term survival has been significantly improved.

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“…Endoscopic ultrasonography is essential in the diagnosis by tissue sampling (FNA or FNB) and in the loco-regional staging of pancreatic cancer. The progress in EUS techniques makes it an important tool in the management, staging, and vascular evaluation of pancreatic cancer 7 .…”

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confidence: 99%

Role of endoscopic ultrasound in staging and vascular assessment of pancreatic cancer

El-Nady

Hassan

Haridy

et al. 2023

Preprint

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Background: computed tomography (CT) of the abdomen with contrast is the gold standard method for the evaluation of pancreatic cancer concerning staging and vascular assessment. however, not all patients can be evaluated by contrast-enhanced CT abdomen as those with an allergy to the contrast agent, pregnancy, and renal impairment, in addition to hazards of radiation and non-availability of tissue sampling in CECT abdomen .so this study was designed to evaluate the diagnostic ability of Endoscopic Ultrasound for staging and vascular assessment of pancreatic cancer in comparison to CT abdomen with contrast. Method: fifty patients with cancer pancreas were evaluated by CECT and EUS as regard staging and vascular invasion. The vascular assessment was done by dividing the EUS findings into three types by the relationship between tumors and major vessels, type 1, clear invasion, encasement of the vessel by a tumor or tumor that contacts a vessel wall more than 180o; type2, Abutment, a tumor that contacts a vessel wall but less than 180o and type 3, clear non-invasion, the existence of distance between a tumor and a vessel. We regarded type 1 and type 2 as signs of vascular invasion and type 3 as a sign of vascular non-invasion, these findings were compared with the findings of the CECT abdomen. The endoscopist was blind to the CT result before the EUS examination. Result: as regards staging of pancreatic cancer EUS showed sensitivity, specificity, and accuracy of 100% for all. and as regard vascular invasion EUS showed sensitivity, specificity, and accuracy of 100%,95.93%, and 96% respectively for venous invasion and 95.65%,100%, and 99.5% for arterial invasion. Conclusion: EUS can evaluate staging and vascular invasion of pancreatic cancer with very high sensitivity, specificity, and accuracy to the extent it can replace CT in evaluation, with the superiority of EUS due to tissue sampling.

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The Role of Endoscopic Ultrasonography in the Diagnosis and Staging of Pancreatic Cancer

Cited by 15 publications

References 191 publications

Grading pancreatic adenocarcinomas on fine needle aspiration cytology. The outstanding issues

Grading pancreatic adenocarcinomas on fine needle aspiration cytology. The outstanding issues

Synchronous Pancreatic Ductal Adenocarcinoma in the Head and Tail, a Double Trouble: A Case Report and Literature Review

Role of endoscopic ultrasound in staging and vascular assessment of pancreatic cancer

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