Natural History of Branch Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas

Maguchi, Hiroyuki; Tanno, Satoshi; Mizuno, Nobumasa; Hanada, Keiji; Kobayashi, Go; Hatori, Takashi; Sadakari, Yoshihiko; Yamaguchi, Taketo; Tobita, Kosuke; Doi, Ryuichiro; Yanagisawa, Akio; Tanaka, Masao

doi:10.1097/mpa.0b013e31820a5975

Cited by 214 publications

(122 citation statements)

References 20 publications

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“…1). Of these studies, 33 investigated mural nodules5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 21 examined dilatation of the main pancreatic duct (MPD)7 9, 15 16, 18 21, 23 26, 27 30, 32 36, 38, 39, 40, 41, 42, 43, 44, 45, 46, 21 analysed cyst size5 7, 8, 9 14, 15 18, 20 23, 25 27, 28 31, 36 38, 40 41, 43 47, 48, 49, 17 assessed CA19‐9 increase…”

Section: Resultsmentioning

confidence: 99%

Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas

et al. 2018

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BackgroundEstimation of the risk of malignancy in intraductal papillary mucinous neoplasia (IPMN) of the pancreas is a clinical challenge. Several routinely used clinical factors form the basis of the current consensus guidelines. This study aimed to determine the predictive values of the most commonly assessed risk factors.MethodsA meta‐analysis of individual risk factors of malignancy in IPMN was performed. Contingency tables were derived from these data, and sensitivity, specificity, negative and positive predictive values, and diagnostic odds ratios (DOR) were determined. Hierarchical summary receiver operating characteristic (HSROC) curves for each factor were calculated and the respective area under the curve (AUC) was assessed.ResultsA total of 3443 studies were screened initially. Analysis of recent literature revealed 60 studies with 13 relevant risk factors including clinical, serological and radiological parameters. The largest area under the HSROC curve was found for weight loss (0·84) and jaundice/raised bilirubin level (0·80), followed by increased carcinoembryonic antigen (CEA) (0·79) or carbohydrate antigen (CA) 19‐9 (0·78) levels. The most sensitive factors were patient age (71 per cent) and mural nodules (65 per cent), and jaundice/raised bilirubin level (97 per cent) and increased CEA level (95 per cent) were most specific. None of the analysed factors reached a positive or negative level of prediction beyond 90 per cent.ConclusionNone of the established criteria safely distinguishes malignant from non‐malignant lesions.

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Section: Resultsmentioning

confidence: 99%

Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas

et al. 2018

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“…17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 These studies demonstrated that the frequency of PC concomitant with IPMN ranged from 1.1% to 11.2%. As for branch duct IPMN, two working groups of JPS reported that seven PC cases were detected in 349 branch duct IPMN cases during the follow‐up period,17 and that PC concomitant with IPMN may be diagnosed earlier than ordinary PC 18. These observations suggest that patients with IPMN or pancreatic cysts should be carefully observed as having premalignant disease of PC.…”

Section: Risk Factors and Early Diagnosismentioning

confidence: 86%

Early diagnosis of pancreatic cancer: Current trends and concerns

Hanada

Amano

Abe

2017

Annals of Gastroent Surgery

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Early detection of pancreatic cancer (PC) is essential for a better prognosis. Some recent studies have demonstrated that a slight dilatation of the main pancreatic duct (MPD) and small cystic lesions were detected initially in most cases diagnosed at an early stage. Detecting these abnormal findings in cases with high risk factors through an effective screening system including image diagnosis, some biological markers, or familial cancer registrations should contribute to early diagnosis of PC. It has been reported that endoscopic ultrasonography (EUS) is essential for detecting tumors <10 mm with a favorable prognosis. Additionally, EUS‐guided fine‐needle aspiration biopsy is useful for confirming final histological diagnosis. For the diagnosis of stage 0 PC, local irregular stenosis of MPD should be an important initial abnormal sign detected by EUS or magnetic resonance cholangiopancreatography. Cytodiagnosis multiple times using pancreatic juice obtained by endoscopic nasopancreatic drainage should be essential for the final diagnosis. Recently, activities of regional networks between specialist doctors in medical centers and general practitioners for early diagnosis of PC have been reported in Japan. In the future, these activities may play an important role in the early diagnosis of PC.

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“…Tada et al [9] reported that patients with pancreatic cystic lesions were at a high risk of PC, with a standardized incidence rate of 22.5 %. A multicenter study from a working group of the JPS recently reported that PC distinct from branch duct IPMNs developed in seven (2.0 %) of 349 patients during the follow-up period (median 3.7 years) [10]. From these reports, the guidelines recommended that IPMNs and pancreatic cysts should be carefully followed as premalignant diseases of PC [6].…”

Section: Risk Factors For Pcmentioning

confidence: 99%

Diagnostic strategies for early pancreatic cancer

et al. 2014

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Natural History of Branch Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas

Abstract: Most BD-IPMN patients who had no MNs on endoscopic ultrasonography could be managed without surgery. However, careful attention should be paid to disease progression and the development of pancreatic ductal adenocarcinomas during follow-up.

Cited by 214 publications

References 20 publications

Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas

Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas

Early diagnosis of pancreatic cancer: Current trends and concerns

Diagnostic strategies for early pancreatic cancer

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