Value of Cytodiagnosis Using Endoscopic Nasopancreatic Drainage for Early Diagnosis of Pancreatic Cancer

Iiboshi, Tomohiro; Hanada, Keiji; Fukuda, Toshikatsu; Yonehara, Shuji; Sasaki, Tamito; Chayama, Kazuaki

doi:10.1097/mpa.0b013e31823c0b05

Cited by 121 publications

(118 citation statements)

References 29 publications

(16 reference statements)

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“…Recently, there have been some reports of cytodiagnosis multiple times using PJ obtained by ENPD. The sensitivity and accuracy for diagnosis of PCIS using this method was 100%, and 95%, respectively 64, 70, 71. Current Japanese CGL for PC recommends cytodiagnosis multiple times using PJ during ERCP when localized stenosis of MPD is observed by MRCP, EUS, or ERCP 14…”

Section: Diagnosis Of Pcismentioning

confidence: 88%

“…Localized pancreatitis with infiltration of inflammatory cells, fibrosis, and fatty infiltration were frequently observed in the parenchyma around PCIS and atypical epithelium. In addition, there were some PCIS cases with intraductal spread, and mismatch of cancer and MPD stenosis 56, 63, 64, 65, 66, 67, 68, 69. EUS could detect localized pancreatitis, fibrosis, and fatty infiltration around PCIS as a slightly low echoic lesion 56, 66.…”

Section: Diagnosis Of Pcismentioning

confidence: 99%

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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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Section: Diagnosis Of Pcismentioning

confidence: 88%

Section: Diagnosis Of Pcismentioning

confidence: 99%

Early diagnosis of pancreatic cancer: Current trends and concerns

Hanada

Amano

Abe

2017

Annals of Gastroent Surgery

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“…However, EUS seems to be invasive, and the diagnostic ability of EUS to detect early‐stage concomitant PDAC largely depends on the operator's skill; thus, EUS cannot be carried out at the same level globally. Other Japanese investigators62, 63 have demonstrated the important roles of pancreatic juice cytology under ERCP to diagnose stage 0 or I PDAC, although ERCP is still associated with a risk of pancreatitis and is therefore unsuitable for screening. Nevertheless, establishment of a surveillance protocol using an adequate combination of EUS/ERCP for high‐risk patients would contribute to an increase in the number of patients who are diagnosed with resectable concomitant PDAC.…”

Section: Surveillance For Ipmn Without Pancreatectomymentioning

confidence: 99%

Comparison of guidelines for intraductal papillary mucinous neoplasm: What is the next step beyond the current guidelines?

Nakamura

Miyasaka

Sadakari

et al. 2017

Annals of Gastroent Surgery

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Management of intraductal papillary mucinous neoplasm is controversial, and several guidelines have aimed to establish an adequate strategy for surgical resection and surveillance. We compared various intraductal papillary mucinous neoplasm guidelines and considered new matters that are pivotal for improved treatment of intraductal papillary mucinous neoplasm. We identified and compared 11 published guidelines, three of which were major guidelines that mainly referred to the diagnosis and treatment of intraductal papillary mucinous neoplasm (International Association of Pancreatology 2012 guidelines, European Study Group on Cystic Tumours of the Pancreas 2013 guidelines, and American Gastroenterological Association 2015 guidelines). The main concerns of these three guidelines were indication for surgery and follow up of non‐resected lesions. Among the differences between the three guidelines, the period of surveillance recommended was the most controversial matter. Meanwhile, several nomograms have been proposed to improve the diagnosis of intraductal papillary mucinous neoplasm from the level of experts' experiences to that of rational systems. We discuss the adequate strategy of surveillance for intraductal papillary mucinous neoplasm with and without pancreatectomy and nomograms aiming to predict the risk of malignancy in patients with intraductal papillary mucinous neoplasm.

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“…The results of ENPD cytodiagnosis and PC diagnosis showed a sensitivity of 100 %, a specificity of 83.3 %, and an accuracy of 95 %. In these 20 patients, no acute pancreatitis after ENPD tube placement occurred [51]. For the early diagnosis of PC with long-term survival, clinical guidelines for PC (2013) recommend the following: First, dilatation of the MPD and the presence of cysts are important indirect signs.…”

Section: Diagnosis Of Pancreatic Carcinoma In Situmentioning

confidence: 99%

“…Ikeda et al [49] reported the value of balloon spot pancreatography for the diagnosis of small pancreatic tumors and the possibility of diagnosing PCIS located at the branch ducts. As for pathological findings of PCIS using resected specimens, localized pancreatitis has been reported in the parenchyma around PCIS and atypical epithelium [50][51][52]. EUS may make possible the diagnosis of localized pancreatitis around PCIS as a slightly low echoic lesion [47].…”

Section: Diagnosis Of Pancreatic Carcinoma In Situmentioning

confidence: 99%