Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study

Ikemoto, Juri and Serikawa, Masahiro and Hanada, Keiji and Eguchi, Noriaki and Sasaki, Tamito and Fujimoto, Yoshifumi and Sugiyama, Shinichiro and Yamaguchi, Atsushi and Noma, Bunjiro and Kamigaki, Michihiro and Minami, Tomoyuki and Okazaki, Akihito and Yukutake, Masanobu and Ishii, Yasutaka and Mouri, Teruo and Shimizu, Akinori and Tsuboi, Tomofumi and Arihiro, Koji and Chayama, Kazuaki (2021) Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study. Diagnostics, 11 (2). p. 287. ISSN 2075-4418

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Abstract

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.

Item Type: Article
Subjects: STM Repository > Medical Science
Depositing User: Managing Editor
Date Deposited: 05 Jan 2023 07:17
Last Modified: 18 Jun 2024 06:47
URI: http://classical.goforpromo.com/id/eprint/2469

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