Multicenter study of early pancreatic cancer in Japan

Kanno, Atsushi; Masamune, Atsushi; Hanada, Keiji; Maguchi, Hiroyuki; Shimizu, Yasuhiro; Ueki, Toshiharu; Hasebe, Osamu; Ohtsuka, Takao; Nakamura, Masafumi; Takenaka, Mamoru; Kitano, Masayuki; Kikuyama, Masataka; Gabata, Toshifumi; Yoshida, Kōji; Sasaki, Tamito; Serikawa, Masahiro; Furukawa, Toru; Yanagisawa, Akio; Shimosegawa, Tooru

doi:10.1016/j.pan.2017.11.007

Cited by 195 publications

(268 citation statements)

References 24 publications

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“…8 Thus, an intensive diagnostic algorithm for early-stage PC is being applied for patients with indirect features that are incidentally detected during imaging. 9,10 Patients with chronic liver disease caused by hepatitis B virus (HBV) or hepatitis C virus (HCV) have an increased risk of developing hepatocellular carcinoma (HCC). 11 Thus, the guidelines strongly recommend that these patients routinely undergo abdominal imaging surveillance for HCC, regardless of whether they have symptoms.…”

mentioning

confidence: 99%

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

Kumagi

Terao

Yokota

et al. 2019

Mayo Clinic Proceedings

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mentioning

confidence: 99%

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

Kumagi

Terao

Yokota

et al. 2019

Mayo Clinic Proceedings

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“…The prognosis of PDAC is extremely poor due to in part to difficulty of diagnosis in the early stages . At present, there is no definitive screening method for PDAC, and various methods are used clinically, including ultrasonography and computed tomography, for imaging‐based diagnosis and determination of tumor markers in blood . With regard to blood test tumor markers, CA19‐9, Span‐1, CA50, CA242, DUPAN‐2, and TAG‐72 are categorized as glucose‐chain antigens; CEA is an embryonic antigen that is typically present in high levels in PDAC, although not in all cases.…”

Section: Discussionmentioning

confidence: 99%

“…12 At present, there is no definitive screening method for PDAC, and various methods are used clinically, including ultrasonography and computed tomography, for imaging-based diagnosis and determination of tumor markers in blood. 13 With regard to blood test tumor markers, CA19-9, 14 Span-1, 15 CA50, CA242, DUPAN-2, and TAG-72 [16][17][18] are categorized as glucose-chain antigens; CEA is an embryonic antigen 19 that is typically present in high levels in PDAC, although not in all cases. In addition to these conventional tumor markers, a new approach has been developed using excreted small particles, called exosomes; these are believed to include molecules specific for cancers, 20 although the analysis methods are still under development.…”

Section: Discussionmentioning

confidence: 99%

Development of novel diagnostic system for pancreatic cancer, including early stages, measuring mRNA of whole blood cells

et al. 2019

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Pancreatic ductal adenocarcinoma ( PDAC ) is the most life‐threating disease among all digestive system malignancies. We developed a blood mRNA PDAC screening system using real‐time detection PCR to detect the expression of 56 genes, to discriminate PDAC from noncancer subjects. We undertook a clinical study to assess the performance of the developed system. We collected whole blood RNA from 53 PDAC patients, 102 noncancer subjects, 22 patients with chronic pancreatitis, and 23 patients with intraductal papillary mucinous neoplasms in a per protocol analysis. The sensitivity of the system for PDAC diagnosis was 73.6% (95% confidence interval, 59.7%‐84.7%). The specificity for noncancer volunteers, chronic pancreatitis, and patients with intraductal papillary mucinous neoplasms was 64.7% (54.6%‐73.9%), 63.6% (40.7%‐82.8%), and 47.8% (26.8%‐69.4%), respectively. Importantly, the sensitivity of this system for both stage I and stage II PDAC was 78.6% (57.1%‐100%), suggesting that detection of PDAC by the system is not dependent on the stage of PDAC . These results indicated that the screening system, relying on assessment of changes in mRNA expression in blood cells, is a viable alternative screening strategy for PDAC.

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“…However, in CP patients, the diagnostic ability of EUS‐FNA is reduced. When evidence of malignancy is not obtained by EUS‐FNA but a malignant lesion is suspected for reasons such as CP status, MPD stenosis, or caudal MPD dilation, then cytology by ERCP and re‐examination of EUS‐FNA are preferable. In addition, K‐ras mutation analysis is reportedly effective for diagnosing pancreatic cancer .…”

Section: Discussionmentioning

confidence: 99%

Features of chronic pancreatitis by endoscopic ultrasound influence the diagnostic accuracy of endoscopic ultrasound‐guided fine‐needle aspiration of small pancreatic lesions

Kurita

Kuwahara

Hara

et al. 2019

Digestive Endoscopy

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Background and Aim In chronic pancreatitis (CP) patients, diagnosis of small pancreatic lesions by endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) is challenging. Thus, the aim of the present study was to investigate whether CP influences the diagnostic ability of EUS‐FNA for pancreatic lesions ≤10 mm. Methods One hundred and seventeen patients who underwent EUS‐FNA for pancreatic lesions ≤10 mm in size were enrolled. Patients were classified into two groups based on features of CP observed by EUS (EUS‐CP features) in accordance with the Rosemont classification. The CP group was defined as cases consistent with CP or suggestive of CP, and the non‐CP group was defined as cases indeterminate for CP or normal. Factors influencing the diagnostic accuracy of EUS‐FNA and CP status in pancreatic tumors were also investigated. Results Diagnostic ability of EUS‐FNA (overall cases, non‐CP vs CP) had sensitivity (80.4%, 96.7% vs 57.1%; P < 0.001), specificity (100%, 100% vs 100%; P > 0.05), and accuracy (91.5%, 98.6% vs 80.4%; P = 0.001). In multivariate analysis of factors influencing the accuracy of EUS‐FNA, CP significantly lowered the accuracy (P = 0.048; odds ratio [OR] = 9.21). Among pancreatic cancer patients, the number of CP patients was significantly higher than the number of patients with benign lesions (P = 0.023). In multivariate analysis, lobularity without honeycombing was more frequently observed in cases of pancreatic cancer (P = 0.018; OR, 12.65). Conclusion Endoscopic ultrasound‐guided FNA offers high accuracy for small pancreatic lesions ≤10 mm. However, in cases with CP, the diagnostic ability of EUS‐FNA is significantly reduced.

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Multicenter study of early pancreatic cancer in Japan

Cited by 195 publications

References 24 publications

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

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

Development of novel diagnostic system for pancreatic cancer, including early stages, measuring mRNA of whole blood cells

Features of chronic pancreatitis by endoscopic ultrasound influence the diagnostic accuracy of endoscopic ultrasound‐guided fine‐needle aspiration of small pancreatic lesions

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