Cargando…

Prognostic influence of endoscopic ultrasound-guided fine needle aspiration in IPMN-derived invasive adenocarcinoma

BACKGROUND: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for mucinous cystic neoplasm of the pancreas carries a potential risk of inducing peritoneal tumor cell dissemination. We investigated the diagnostic yield and safety of EUS-FNA-based cytology of cells obtained from the pancre...

Descripción completa

Detalles Bibliográficos
Autores principales: Suzuki, Rei, Irie, Hiroki, Takagi, Tadayuki, Sugimoto, Mitsuru, Konno, Naoki, Sato, Yuki, Watanabe, Ko, Nakamura, Jun, Marubashi, Shigeru, Hikichi, Takuto, Ohira, Hiromasa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186033/
https://www.ncbi.nlm.nih.gov/pubmed/30314433
http://dx.doi.org/10.1186/s12885-018-4896-2
_version_ 1783362794033250304
author Suzuki, Rei
Irie, Hiroki
Takagi, Tadayuki
Sugimoto, Mitsuru
Konno, Naoki
Sato, Yuki
Watanabe, Ko
Nakamura, Jun
Marubashi, Shigeru
Hikichi, Takuto
Ohira, Hiromasa
author_facet Suzuki, Rei
Irie, Hiroki
Takagi, Tadayuki
Sugimoto, Mitsuru
Konno, Naoki
Sato, Yuki
Watanabe, Ko
Nakamura, Jun
Marubashi, Shigeru
Hikichi, Takuto
Ohira, Hiromasa
author_sort Suzuki, Rei
collection PubMed
description BACKGROUND: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for mucinous cystic neoplasm of the pancreas carries a potential risk of inducing peritoneal tumor cell dissemination. We investigated the diagnostic yield and safety of EUS-FNA-based cytology of cells obtained from the pancreatic invasion site of intraductal papillary-mucinous neoplasm-derived adenocarcinoma (IPMC). METHODS: We included 22 surgically resected IPMCs and 84 pancreatic ductal adenocarcinomas (PDACs). Among the IPMC cases, 14 did not undergo EUS-FNA before surgical resection. The diagnostic yield of EUS-FNA was compared between IPMC and PDAC. Additionally, prognosis (relapse-free and overall survival time after resection) and the rate of peritoneal dissemination were compared among IPMC with EUS-FNA, IPMC without EUS-FNA, and PDAC. A survival analysis was performed using the Kaplan-Meier method and log-rank test. RESULTS: (EUS-FNA diagnosis) There were no significant differences in the number of needle passages (PDAC 2.5 vs. IPMC 2.0 passages, P = 0.84) or puncture route (stomach/duodenum: 2/6 vs. 45/39, P = 0.29). However, the correct diagnosis rate was significantly higher in PDAC (92.9%) than in IPMC (62.5%) (P = 0.03). No procedure-related adverse events occurred. Peritoneal lavage cytology performed during the operation was negative in all cases. (Prognosis) Among IPMC with EUS-FNA, IPMC without EUS-FNA, and PDAC, there were no significant differences in relapse-free survival (21.0 vs. 22.4 vs. 12.5 months, respectively; P = 0.64) or overall survival time (35.5 vs. 53.1 vs. 35.9 months, respectively; P = 0.42), and peritoneal dissemination was detected during the observation period in 25%, 28.5%, and 21.4% cases, respectively (P = 0.82). CONCLUSION: Even though a correct diagnosis was more difficult to obtain in IPMC than in PDAC, IPMC allows specimens to be obtained without influencing the rate of recurrence and prognosis.
format Online
Article
Text
id pubmed-6186033
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-61860332018-10-19 Prognostic influence of endoscopic ultrasound-guided fine needle aspiration in IPMN-derived invasive adenocarcinoma Suzuki, Rei Irie, Hiroki Takagi, Tadayuki Sugimoto, Mitsuru Konno, Naoki Sato, Yuki Watanabe, Ko Nakamura, Jun Marubashi, Shigeru Hikichi, Takuto Ohira, Hiromasa BMC Cancer Research Article BACKGROUND: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for mucinous cystic neoplasm of the pancreas carries a potential risk of inducing peritoneal tumor cell dissemination. We investigated the diagnostic yield and safety of EUS-FNA-based cytology of cells obtained from the pancreatic invasion site of intraductal papillary-mucinous neoplasm-derived adenocarcinoma (IPMC). METHODS: We included 22 surgically resected IPMCs and 84 pancreatic ductal adenocarcinomas (PDACs). Among the IPMC cases, 14 did not undergo EUS-FNA before surgical resection. The diagnostic yield of EUS-FNA was compared between IPMC and PDAC. Additionally, prognosis (relapse-free and overall survival time after resection) and the rate of peritoneal dissemination were compared among IPMC with EUS-FNA, IPMC without EUS-FNA, and PDAC. A survival analysis was performed using the Kaplan-Meier method and log-rank test. RESULTS: (EUS-FNA diagnosis) There were no significant differences in the number of needle passages (PDAC 2.5 vs. IPMC 2.0 passages, P = 0.84) or puncture route (stomach/duodenum: 2/6 vs. 45/39, P = 0.29). However, the correct diagnosis rate was significantly higher in PDAC (92.9%) than in IPMC (62.5%) (P = 0.03). No procedure-related adverse events occurred. Peritoneal lavage cytology performed during the operation was negative in all cases. (Prognosis) Among IPMC with EUS-FNA, IPMC without EUS-FNA, and PDAC, there were no significant differences in relapse-free survival (21.0 vs. 22.4 vs. 12.5 months, respectively; P = 0.64) or overall survival time (35.5 vs. 53.1 vs. 35.9 months, respectively; P = 0.42), and peritoneal dissemination was detected during the observation period in 25%, 28.5%, and 21.4% cases, respectively (P = 0.82). CONCLUSION: Even though a correct diagnosis was more difficult to obtain in IPMC than in PDAC, IPMC allows specimens to be obtained without influencing the rate of recurrence and prognosis. BioMed Central 2018-10-12 /pmc/articles/PMC6186033/ /pubmed/30314433 http://dx.doi.org/10.1186/s12885-018-4896-2 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Suzuki, Rei
Irie, Hiroki
Takagi, Tadayuki
Sugimoto, Mitsuru
Konno, Naoki
Sato, Yuki
Watanabe, Ko
Nakamura, Jun
Marubashi, Shigeru
Hikichi, Takuto
Ohira, Hiromasa
Prognostic influence of endoscopic ultrasound-guided fine needle aspiration in IPMN-derived invasive adenocarcinoma
title Prognostic influence of endoscopic ultrasound-guided fine needle aspiration in IPMN-derived invasive adenocarcinoma
title_full Prognostic influence of endoscopic ultrasound-guided fine needle aspiration in IPMN-derived invasive adenocarcinoma
title_fullStr Prognostic influence of endoscopic ultrasound-guided fine needle aspiration in IPMN-derived invasive adenocarcinoma
title_full_unstemmed Prognostic influence of endoscopic ultrasound-guided fine needle aspiration in IPMN-derived invasive adenocarcinoma
title_short Prognostic influence of endoscopic ultrasound-guided fine needle aspiration in IPMN-derived invasive adenocarcinoma
title_sort prognostic influence of endoscopic ultrasound-guided fine needle aspiration in ipmn-derived invasive adenocarcinoma
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186033/
https://www.ncbi.nlm.nih.gov/pubmed/30314433
http://dx.doi.org/10.1186/s12885-018-4896-2
work_keys_str_mv AT suzukirei prognosticinfluenceofendoscopicultrasoundguidedfineneedleaspirationinipmnderivedinvasiveadenocarcinoma
AT iriehiroki prognosticinfluenceofendoscopicultrasoundguidedfineneedleaspirationinipmnderivedinvasiveadenocarcinoma
AT takagitadayuki prognosticinfluenceofendoscopicultrasoundguidedfineneedleaspirationinipmnderivedinvasiveadenocarcinoma
AT sugimotomitsuru prognosticinfluenceofendoscopicultrasoundguidedfineneedleaspirationinipmnderivedinvasiveadenocarcinoma
AT konnonaoki prognosticinfluenceofendoscopicultrasoundguidedfineneedleaspirationinipmnderivedinvasiveadenocarcinoma
AT satoyuki prognosticinfluenceofendoscopicultrasoundguidedfineneedleaspirationinipmnderivedinvasiveadenocarcinoma
AT watanabeko prognosticinfluenceofendoscopicultrasoundguidedfineneedleaspirationinipmnderivedinvasiveadenocarcinoma
AT nakamurajun prognosticinfluenceofendoscopicultrasoundguidedfineneedleaspirationinipmnderivedinvasiveadenocarcinoma
AT marubashishigeru prognosticinfluenceofendoscopicultrasoundguidedfineneedleaspirationinipmnderivedinvasiveadenocarcinoma
AT hikichitakuto prognosticinfluenceofendoscopicultrasoundguidedfineneedleaspirationinipmnderivedinvasiveadenocarcinoma
AT ohirahiromasa prognosticinfluenceofendoscopicultrasoundguidedfineneedleaspirationinipmnderivedinvasiveadenocarcinoma