The safety and benefit of pancreatic juice cytology under ERCP in IPMN patients

Yoshioka, Teppei; Shigekawa, Minoru; Yamai, Takuo; Suda, Takahiro; Kegasawa, Tadashi; Iwahashi, Kiyoshi; Ikezawa, Kenji; Sakamori, Ryotaro; Yakushijin, Takayuki; Hiramatsu, Naoki; Tatsumi, Tomohide; Takehara, Tetsuo

doi:10.1016/j.pan.2016.08.009

Cited by 14 publications

(13 citation statements)

References 28 publications

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“…One potential drawback of ERCP assessment of pancreatic juice cytology, however, is post-ERCP pancreatitis (PEP). 75 Rates of PEP in patients diagnosed with BD-IPMN and MD-IPMN were 17.2% and 3.6%, respectively. 75 Another drawback of cytology by the transpapillary approach is the poor sensitivity of this method, despite its high specificity.…”

Section: Assessment Of Pancreatic Juice By a Transpapillary Approachmentioning

confidence: 89%

“…75 Rates of PEP in patients diagnosed with BD-IPMN and MD-IPMN were 17.2% and 3.6%, respectively. 75 Another drawback of cytology by the transpapillary approach is the poor sensitivity of this method, despite its high specificity. New methods, including immunohistochemical (IHC) analysis of markers, are warranted to improve diagnostic accuracy.…”

Section: Assessment Of Pancreatic Juice By a Transpapillary Approachmentioning

confidence: 89%

“…Moreover, three IPMN‐concomitant pancreatic ductal adenocarcinomas (PDAC) were diagnosed only by ERCP that included pancreatic juice cytology. One potential drawback of ERCP assessment of pancreatic juice cytology, however, is post‐ERCP pancreatitis (PEP) . Rates of PEP in patients diagnosed with BD‐IPMN and MD‐IPMN were 17.2% and 3.6%, respectively …”

Section: Methodsmentioning

confidence: 99%

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Endoscopic diagnosis of cystic lesions of the pancreas

Kamata

Kitano

2018

Digestive Endoscopy

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Endoscopic methods are increasingly used in the diagnosis of cystic lesions of the pancreas. The two major endoscopic approaches are endoscopic ultrasonography (EUS) and transpapillary diagnosis. EUS-guided fine-needle aspiration cytology and EUS-guided fine needle-based confocal laser endomicroscopy have been used in the differential diagnosis of mucinous and non-mucinous pancreatic cysts. EUS is the most sensitive modality for detecting mural nodules (MN) in intraductal papillary mucinous neoplasms (IPMN). Contrast-enhanced harmonic EUS (CH-EUS), as an add-on to EUS, is useful for identifying and characterizing MN. Recent studies show that CH-EUS has a sensitivity of 60-100% and a specificity of 75-92.9% for diagnosing malignant cysts. Intraductal ultrasonography and peroral pancreatoscopy are especially useful for detecting MN and IPMN. A recent meta-analysis showed that cytological assessment of pancreatic juice using a transpapillary approach had a pooled sensitivity, specificity, and accuracy of 35.1%, 97.2%, and 92.9%, respectively, for diagnosing malignant IPMN. Further studies are warranted to determine the indications for each of these novel techniques in assessing cystic lesions of the pancreas.

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Section: Assessment Of Pancreatic Juice By a Transpapillary Approachmentioning

confidence: 89%

Section: Assessment Of Pancreatic Juice By a Transpapillary Approachmentioning

confidence: 89%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic diagnosis of cystic lesions of the pancreas

Kamata

Kitano

2018

Digestive Endoscopy

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“…However, the rate of malignant IPMN in patients with HRS and WF were reported to be 49%-57% and 16%-27%, respectively. 2,3 Although the presence of mural nodules (MN) on endoscopic ultrasonography (EUS) has been shown to be a good predictor of malignant branch duct IPMN (BD-IPMN), [4][5][6][7][8][9][10] about 10% of malignant BD-IPMNs have been reported in patients without MN. 8,11,12 As mentioned above, the diagnostic ability of the imaging studies for malignant IPMN is limited.…”

Section: Ipmnmentioning

confidence: 99%

The efficacy of pancreatic juice cytology with liquid-based cytology for evaluating malignancy in patients with intraductal papillary mucinous neoplasm

Miyamoto

Matsumoto²,

Kato

et al. 2020

Preprint

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Background: Pancreatic juice cytology (PJC) is a tool for diagnosing malignant intraductal papillary mucinous neoplasm (IPMN); however, the accuracy is insufficient using the conventional method. Liquid-based cytology (LBC) improves the cell recovery rate, and almost all cells can be evaluated. We evaluated the efficacy of PJC with LBC for malignant IPMN. Methods: We retrospectively analyzed 90 patients with suspected malignant IPMN who underwent PJC before pancreatectomy. PJC with smear and LBC methods was conducted in 52 patients (between June 2003 to December 2011) and 38 patients (between January 2012 to December 2018). Based on the imaging studies, all of the patients were classified according to the international consensus guidelines for IPMN revised in 2017.Results: Of the 90 patients, 43 (48%) had malignant IPMN (high-grade dysplasia or invasive carcinoma), and the remaining patients had non-malignant IPMN (intermediate- or low-grade dysplasia). LBC increased the accuracy of PJC for the diagnosis of malignant IPMN (smear method: 56% [29/52] vs. LBC method: 76% [29/38]; P = 0.044). In a multivariate analysis, LBC was a significant factor influencing the accurate diagnosis of PJC (odds ratio: 3.52; P = 0.021). Furthermore, LBC increased the accuracy of PJC for malignant IPMN in patients with worrisome features (smear method: 66% [19/29] vs. LBC method: 93% [14/15]; P = 0.043). Conclusions: LBC increases the accuracy of PJC for diagnosing malignant IPMN compared with the conventional smear method.

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“…However, the sensitivity of PJC for malignant IPMN was found to be only 35% in a meta-analysis, 13 and the accuracy was also unsatisfactory (33%-64%). 2,[14][15] Furthermore, the incidence of post-ERCP pancreatitis (PEP) was also reported to be about 8%-25%. 2,[14][15][16] These are challenges that must be considered when performing PJC for the diagnosis of malignant IPMN.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of pancreatic juice cytology with liquid-based cytology for evaluating malignancy in patients with intraductal papillary mucinous neoplasm

Miyamoto

Matsumoto

Kato

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Pancreatic juice cytology (PJC) is a tool for diagnosing malignant intraductal papillary mucinous neoplasm (IPMN); however, the accuracy is insufficient using the conventional method. Liquid-based cytology (LBC) improves the cell recovery rate, and almost all cells can be evaluated. We evaluated the efficacy of PJC with LBC for malignant IPMN. Methods We retrospectively analyzed 90 patients with suspected malignant IPMN who underwent PJC before pancreatectomy. PJC with smear and LBC methods was conducted in 52 patients (between June 2003 to December 2011) and 38 patients (between January 2012 to December 2018). Based on the imaging studies, all of the patients were classified according to the international consensus guidelines for IPMN revised in 2017. Results Of the 90 patients, 43 (48%) had malignant IPMN (high-grade dysplasia or invasive carcinoma), and the remaining patients had non-malignant IPMN (intermediate- or low-grade dysplasia). LBC increased the accuracy of PJC for the diagnosis of malignant IPMN (smear method: 56% [29/52] vs. LBC method: 76% [29/38]; P = 0.044). In a multivariate analysis, LBC was a significant factor influencing the accurate diagnosis of PJC (odds ratio: 3.52; P = 0.021). Furthermore, LBC increased the accuracy of PJC for malignant IPMN in patients with worrisome features (smear method: 66% [19/29] vs. LBC method: 93% [14/15]; P = 0.043). Conclusions LBC increases the accuracy of PJC for diagnosing malignant IPMN compared with the conventional smear method.

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The safety and benefit of pancreatic juice cytology under ERCP in IPMN patients

Cited by 14 publications

References 28 publications

Endoscopic diagnosis of cystic lesions of the pancreas

Endoscopic diagnosis of cystic lesions of the pancreas

The efficacy of pancreatic juice cytology with liquid-based cytology for evaluating malignancy in patients with intraductal papillary mucinous neoplasm

The efficacy of pancreatic juice cytology with liquid-based cytology for evaluating malignancy in patients with intraductal papillary mucinous neoplasm

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