Early Detection of Pancreatic Cancer in Patients With Chronic Liver Disease Under Hepatocellular Carcinoma Surveillance

Kumagi, Teru; Terao, Takashi; Yokota, Tomoyuki; Azemoto, Nobuaki; Kuroda, Taira; Imamura, Yoshiki; Uesugi, Kentaro; Kisaka, Yoshiyasu; Tanaka, Yoshinori; Shibata, Naozumi; Koizumi, Masaru; Ohno, Yoshinori; Yukimoto, Atsushi; Tange, Kazuhiro; Nishiyama, Mari; Kanemitsu, Kozue; Miyake, Teruki; Miyata, Hideki; Ishii, Hiroshi; Hiasa, Yoichi

doi:10.1016/j.mayocp.2018.12.034

Cited by 9 publications

(8 citation statements)

References 20 publications

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“…In this study, patients with PDAC were frequently diagnosed during the screening or surveillance for other diseases by CT and indirect imaging findings were observed in 43%. In recent years, it has been reported that patients with chronic liver disease who underwent surveillance for hepatocellular carcinoma may be diagnosed with PDAC at an early stage [25]. In addition to MPD abnormalities, localized pancreatic atrophy observed on CT may be one of the important indirect findings of PCIS [8,9], and localized pancreatic atrophy of the pancreas was found in 33% of the patients in this study.…”

Section: Discussionsupporting

confidence: 51%

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

et al. 2021

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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.

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Section: Discussionsupporting

confidence: 51%

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

et al. 2021

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“…A recent study of patients with chronic hepatobiliary disease outside the SOT setting suggested the usefulness of early and incidental PC detection during surveillance imaging for hepatic disease. 4 However, our analysis showed that survival after a PC diagnosis was very poor, regardless of stage at diagnosis, with a median survival of 4 months for the overall group. Survival was similarly poor for liver and other organ recipients.…”

Section: Resultsmentioning

confidence: 64%

“…3 However, a recent study suggested the usefulness of early detection of PC as an incidental nding (i.e., detection of PC in the absence of symptoms or screening) during surveillance imaging in patients with chronic liver disease. 4 A study in Japan found that over 50% of early stage PCs are found incidentally during evaluations for other conditions. 5 Several risk factors for PC have been identi ed from studies in the general population.…”

Section: Introductionmentioning

confidence: 99%

Pancreatic cancer among solid organ transplant recipients in the United States

Tanaka

Lynch

et al. 2022

J Cancer Res Clin Oncol

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IntroductionPancreatic cancer (PC) in solid organ transplant (SOT) recipients is not well studied. Some PC cases may be incidentally detected during hepatobiliary imaging. MethodsWe evaluated PC among 374,106 SOT recipients during 1995-2017 in the United States using linked data from the national transplant registry and multiple state/regional cancer registries. Standardized incidence ratios (SIRs) were used to compare PC risk in recipients to the general population. We used multivariate Poisson regression to identify independent risk factors for PC. We assessed survival after PC diagnosis using Kaplan-Meier curves and log-rank tests. ResultsSOT recipients had elevated incidence for PC compared with the general population (SIR 1.40, 95%CI 1.29-1.52), and this increase was strongest in liver recipients (1.65, 1.41-1.92). Among all recipients, PC incidence was especially increased for cases arising in the head of the pancreas (SIR 1.50, 95%CI 1.34-1.68) and for cases diagnosed at localized stage (1.85, 1.37-2.44). Among SOT recipients, factors independently associated with increased incidence were consistent with those in general population including male sex, older age, non-O blood type, and history of diabetes. Additionally, compared to other organ recipients, liver transplant recipients had higher PC incidence (adjusted incidence rate ratio 1.28; 95%CI 1.06-1.54). Overall survival after PC diagnosis was poor (median 4 months) and similar between liver and other organ transplant recipients (p = 0.08). ConclusionsPC incidence is elevated among SOT recipients, and more commonly diagnosed in liver transplant recipients perhaps related to incidental detection. However, survival is poor even in liver recipients, arguing against routine PC screening.

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“…After patients with hepatitis C virus (HCV)-related chronic liver disease underwent surveillance for hepatocellular carcinoma (HCC), some patients were diagnosed as having PDAC at a relatively early stage (50). Direct-acting antivirals against HCV, which have recently been introduced as a treatment for HCV, can induce rapid HCV clearance and changes in immune status, including serum interferon levels (51).…”

Section: Discussionmentioning

confidence: 99%

“…These effects may be associated with the occurrence of PDAC. Careful attention should be paid to the pancreas during HCC surveillance (50).…”

Section: Discussionmentioning

confidence: 99%

Involvement of the Interferon Signaling Pathways in Pancreatic Cancer Cells

et al. 2020

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Background/Aim: To examine interferon (IFN) signaling pathways in human pancreatic cancer cells and their therapeutic application for pancreatic ductal adenocarcinoma (PDAC). Materials and Methods: We examined the effects of IFNα on cytotoxicity, migration, as well as on the levels of tolllike receptor (TLR) signaling pathway-associated genes expression in pancreatic cancer cells. We also examined the additive effects of IFNα and poly(I-C) on tyrosine kinase inhibitor (TKI)-induced cytotoxicity. We performed transcriptome analysis (RNA-Seq) of clinical samples and compared the profile between pancreatic intraepithelial neoplasias (PanINs) and PDACs. Results: IFNα suppressed cell viability and cell migration, and affected TLR signaling pathways, in pancreatic cancer cells. TLR3 is one of the potential genes involved in IFNtreated pancreatic cancer cells. Furthermore, similar to IFN, extracellular addition of poly(I-C) enhanced TKI-induced cytotoxicity in pancreatic cancer cells. RNA-Seq analysis demonstrated that IFN signaling is one of the potential pathways involved in the progression of PanIN to PDAC. Conclusion: IFN signaling may be involved in the development of PDAC. Treatments that target the IFN and TLR3 signaling pathways may be therapeutic options against PDAC.

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Early Detection of Pancreatic Cancer in Patients With Chronic Liver Disease Under Hepatocellular Carcinoma Surveillance

Abstract: Objective: To evaluate whether patients with hepatitis B virus (HBV)e and hepatitis C virus (HCV)e related chronic liver disease were diagnosed as having pancreatic cancer (

Cited by 9 publications

References 20 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

Pancreatic cancer among solid organ transplant recipients in the United States

Involvement of the Interferon Signaling Pathways in Pancreatic Cancer Cells

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