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Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study
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...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917700/ https://www.ncbi.nlm.nih.gov/pubmed/33673151 http://dx.doi.org/10.3390/diagnostics11020287 |
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author | Ikemoto, Juri Serikawa, Masahiro Hanada, Keiji Eguchi, Noriaki Sasaki, Tamito Fujimoto, Yoshifumi Sugiyama, Shinichiro Yamaguchi, Atsushi Noma, Bunjiro Kamigaki, Michihiro Minami, Tomoyuki Okazaki, Akihito Yukutake, Masanobu Ishii, Yasutaka Mouri, Teruo Shimizu, Akinori Tsuboi, Tomofumi Arihiro, Koji Chayama, Kazuaki |
author_facet | Ikemoto, Juri Serikawa, Masahiro Hanada, Keiji Eguchi, Noriaki Sasaki, Tamito Fujimoto, Yoshifumi Sugiyama, Shinichiro Yamaguchi, Atsushi Noma, Bunjiro Kamigaki, Michihiro Minami, Tomoyuki Okazaki, Akihito Yukutake, Masanobu Ishii, Yasutaka Mouri, Teruo Shimizu, Akinori Tsuboi, Tomofumi Arihiro, Koji Chayama, Kazuaki |
author_sort | Ikemoto, Juri |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7917700 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79177002021-03-02 Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study Ikemoto, Juri Serikawa, Masahiro Hanada, Keiji Eguchi, Noriaki Sasaki, Tamito Fujimoto, Yoshifumi Sugiyama, Shinichiro Yamaguchi, Atsushi Noma, Bunjiro Kamigaki, Michihiro Minami, Tomoyuki Okazaki, Akihito Yukutake, Masanobu Ishii, Yasutaka Mouri, Teruo Shimizu, Akinori Tsuboi, Tomofumi Arihiro, Koji Chayama, Kazuaki Diagnostics (Basel) Article 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. MDPI 2021-02-12 /pmc/articles/PMC7917700/ /pubmed/33673151 http://dx.doi.org/10.3390/diagnostics11020287 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ikemoto, Juri Serikawa, Masahiro Hanada, Keiji Eguchi, Noriaki Sasaki, Tamito Fujimoto, Yoshifumi Sugiyama, Shinichiro Yamaguchi, Atsushi Noma, Bunjiro Kamigaki, Michihiro Minami, Tomoyuki Okazaki, Akihito Yukutake, Masanobu Ishii, Yasutaka Mouri, Teruo Shimizu, Akinori Tsuboi, Tomofumi Arihiro, Koji Chayama, Kazuaki Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study |
title | Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study |
title_full | Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study |
title_fullStr | Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study |
title_full_unstemmed | Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study |
title_short | Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study |
title_sort | clinical analysis of early-stage pancreatic cancer and proposal for a new diagnostic algorithm: a multicenter observational study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917700/ https://www.ncbi.nlm.nih.gov/pubmed/33673151 http://dx.doi.org/10.3390/diagnostics11020287 |
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