Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study
| Autor: | Atsushi Yamaguchi, Tamito Sasaki, Masahiro Serikawa, Akihito Okazaki, Kazuaki Chayama, Masanobu Yukutake, Akinori Shimizu, Yoshifumi Fujimoto, Shinichiro Sugiyama, Noriaki Eguchi, Teruo Mouri, Tomoyuki Minami, Keiji Hanada, Tomofumi Tsuboi, Yasutaka Ishii, Michihiro Kamigaki, Koji Arihiro, Bunjiro Noma, Juri Ikemoto |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
endoscopic retrograde cholangiopancreatography endocrine system diseases Clinical Biochemistry pancreatic ductal adenocarcinoma Asymptomatic Article 03 medical and health sciences 0302 clinical medicine Pancreatic cancer medicine Stage (cooking) endoscopic ultrasonography lcsh:R5-920 Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test Clinical pathology business.industry Magnetic resonance imaging medicine.disease digestive system diseases Pancreatic Duct Stenosis multicenter study 030220 oncology & carcinogenesis Adenocarcinoma 030211 gastroenterology & hepatology medicine.symptom lcsh:Medicine (General) business Algorithm early diagnosis |
| Zdroj: | Diagnostics Diagnostics, Vol 11, Iss 287, p 287 (2021) Volume 11 Issue 2 |
| ISSN: | 2075-4418 |
| Popis: | Early diagnosis of pancreatic ductal adenocarcinoma (PDAC) is challenging but essential for improving its poor prognosis. We established a multicenter study to clarify the clinicopathological features, and to propose new algorithm for early diagnosis of PDAC. Ninety-six patients with stage 0 and IA PDAC were enrolled from 13 high-volume centers. Overall, 70% of the patients were asymptomatic. The serum pancreatic enzyme levels were abnormal in half of the patients. The sensitivity of endoscopic ultrasonography (EUS) for detecting small PDAC was superior to computed tomography and magnetic resonance imaging (MRI) (82%, 58%, and 38%, respectively). Indirect imaging findings were useful to detect early-stage PDAC especially, main pancreatic duct stenosis on MRI had the highest positive rate of 86% in stage 0 patients. For preoperative pathological diagnosis, the sensitivity of endoscopic retrograde cholangiopancreatography (ERCP)-associated pancreatic juice cytology was 84%. Among the stage IA patients, EUS-guided fine-needle aspiration revealed adenocarcinoma in 93% patients. For early diagnosis of PDAC, it is essential to identify asymptomatic patients and ensure close examinations of indirect imaging findings and standardization of preoperative pathological diagnosis. Therefore, a new diagnostic algorithm based on tumor size and imaging findings should be developed. |
| Databáze: | OpenAIRE |
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