The role of endoscopic ultrasound in pancreatic cancer screening

Bhutani, Manoop S.; Koduru, Pramoda; Joshi, Virendra; Saxena, Payal; Suzuki, Rei; Irisawa, Atsushi; Yamao, Kenji

doi:10.4103/2303-9027.175876

Cited by 48 publications

(33 citation statements)

References 79 publications

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“…Solid pancreatic lesions (SPL) are mostly malignant with 5-year survival rates of less than 5%[ 1 ]. Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) is a very good tool for the diagnosis of malignant SPL, with sensitivity and specificity rates of 91% and 94%, respectively[ 2 , 3 ], but it shows false negative results in approximately 15% of cases[ 4 ]. Strict follow up for negative FNA lesions is mandatory and may necessitate the use of invasive techniques to reach a full diagnosis, such as diagnostic laparoscopy[ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions

Okasha

Elkholy

El-Sayed

et al. 2017

WJG

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AIMTo evaluate the accuracy of the elastography score combined to the strain ratio in the diagnosis of solid pancreatic lesions (SPL).METHODSA total of 172 patients with SPL identified by endoscopic ultrasound were enrolled in the study to evaluate the efficacy of elastography and strain ratio in differentiating malignant from benign lesions. The semi quantitative score of elastography was represented by the strain ratio method. Two areas were selected, area (A) representing the region of interest and area (B) representing the normal area. Area (B) was then divided by area (A). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated by comparing diagnoses made by elastography, strain ratio and final diagnoses.RESULTSSPL were shown to be benign in 49 patients and malignant in 123 patients. Elastography alone had a sensitivity of 99%, a specificity of 63%, and an accuracy of 88%, a PPV of 87% and an NPV of 96%. The best cut-off level of strain ratio to obtain the maximal area under the curve was 7.8 with a sensitivity of 92%, specificity of 77%, PPV of 91%, NPV of 80% and an accuracy of 88%. Another estimated cut off strain ratio level of 3.8 had a higher sensitivity of 99% and NPV of 96%, but with less specificity, PPV and accuracy 53%, 84% and 86%, respectively. Adding both elastography to strain ratio resulted in a sensitivity of 98%, specificity of 77%, PPV of 91%, NPV of 95% and accuracy of 92% for the diagnosis of SPL.CONCLUSIONCombining elastography to strain ratio increases the accuracy of the differentiation of benign from malignant SPL.

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Section: Introductionmentioning

confidence: 99%

Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions

Okasha

Elkholy

El-Sayed

et al. 2017

WJG

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“…The sensitivity and specificity of tumor marker CA19-9 in the diagnosis of pancreatic cancer are 79%-81% and 82%-90%, respectively. However, about 3%-7% of pancreatic cancer patients are Lewis antigen negative and also do not express CA19-9; abnormal CA19-9 levels are not detected in this type of patients[ 20 , 36 , 37 ]. In this study, serum levels of circ-LDLRAD3 were found to be closely related to blood CA19-9 levels.…”

Section: Discussionmentioning

confidence: 99%

Circular RNA circ-LDLRAD3 as a biomarker in diagnosis of pancreatic cancer

Yang

Liu

Guo

et al. 2017

WJG

168

139

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AIMTo analyze the diagnostic value of a circular RNA (circRNA), circ-LDLRAD3, in pancreatic cancer.METHODSExpression levels of circ-LDLRAD3 were tested in both cells and clinical samples; the latter included 30 paired pancreatic cancer tissues and adjacent non-tumorous tissues, 31 plasma samples from patients with pancreatic cancer, and 31 plasma samples from healthy volunteers. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was performed to measure expression levels of circ-LDLRAD3 in cells and clinical samples; then, the relationship between clinicopathological factors of patient samples and expression of circ-LDLRAD3 in pancreatic cancer was analyzed. The diagnostic value of circ-LDLRAD3 was verified by receiver operating characteristic (ROC) curve analysis.RESULTSCirc-LDLRAD3 was up-regulated in pancreatic cancer cell lines (P < 0.01), pancreatic cancer tissues (P < 0.01), and plasma samples from patients with pancreatic cancer (P < 0.01). High expression of circ-LDLRAD3 was significantly associated with venous invasion, lymphatic invasion, and metastasis. The area under the ROC curve of circ-LDLRAD3 alone or combination with CA19-9 was 0.67 and 0.87, respectively, with a sensitivity and specificity of 0.5738 (alone) and 0.7049 (alone), and 0.8033 (combination) and 0.9355 (combination), respectively.CONCLUSIONThese data suggest that circ-LDLRAD3 may be a biomarker in the diagnosis of pancreatic cancer.

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“…However, EUS has become the most sensitive examination for PC in patients with clinical manifestations suggesting PC or high-risk factors for PC. Moreover, EUS-guided fine needle aspiration can confirm the diagnosis of PC by puncturing pancreatic lesions through the gastrointestinal tract wall [ 46 ].…”

Section: Diagnostic Endoscopic Techniquementioning

confidence: 99%

Early Diagnosis to Improve the Poor Prognosis of Pancreatic Cancer

Kikuyama

Kamisawa

Kuruma

et al. 2018

Cancers

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Pancreatic cancer (PC) has a poor prognosis due to delayed diagnosis. Early diagnosis is the most important factor for improving prognosis. For early diagnosis of PC, patients with clinical manifestations suggestive of PC and high risk for developing PC need to be selected for examinations for PC. Signs suggestive of PC (e.g., symptoms, diabetes mellitus, acute pancreatitis, or abnormal results of blood examinations) should not be missed, and the details of risks for PC (e.g., familial history of PC, intraductal mucin producing neoplasm, chronic pancreatitis, hereditary pancreatitis, or life habit) should be understood. Multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) can be performed for diagnosing PC, but the diagnostic ability of these examinations for PC is limited. Endoscopic diagnostic procedures, such as endoscopic ultrasonography, including fine-needle aspiration, and endoscopic retrograde pancreatocholangiography, including Serial Pancreatic-juice Aspiration Cytologic Examination (SPACE), could be recommended for a detailed examination to diagnose pancreatic carcinoma earlier.

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The role of endoscopic ultrasound in pancreatic cancer screening

Cited by 48 publications

References 79 publications

Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions

Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions

Circular RNA circ-LDLRAD3 as a biomarker in diagnosis of pancreatic cancer

Early Diagnosis to Improve the Poor Prognosis of Pancreatic Cancer

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