Role of endoscopic retrograde pancreatography for early detection of pancreatic ductal adenocarcinoma concomitant with intraductal papillary mucinous neoplasm of the pancreas

详细信息    查看全文

• 作者：Takao Ohtsuka (1)
  Noboru Ideno (1)
  Teppei Aso (1)
  Yosuke Nagayoshi (1)
  Hiroshi Kono (1)
  Yasuhisa Mori (1)
  Shunichi Takahata (1)
  Yasunori Oda (2)
  Shinichi Aishima (2)
  Hisato Igarashi (3)
  Tetsuhide Ito (3)
  Kousei Ishigami (4)
  Masafumi Nakamura (1)
  Kazuhiro Mizumoto (1)
  Masao Tanaka (1)
  
• 关键词：ERP ; ERCP ; IPMN ; Pancreatic ductal adenocarcinoma
• 刊名：Journal of Hepato-Biliary-Pancreatic Sciences
• 出版年：2013
• 出版时间：March 2013
• 年：2013
• 卷：20
• 期：3
• 页码：356-361
• 全文大小：400KB
• 参考文献：1. Tanaka M, Chari S, Adsay V, Fernandez-del Castillo C, Falconi M, Shimizu M, et al. International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas. Pancreatology. 2006;6:17-2. CrossRef
  2. Tanaka M, Fernandez-del Castillo C, Adsay V, Chari S, Falconi M, Jang JY, et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 2012;12:183-7.
  3. Yamaguchi K, Ohuchida J, Ohtsuka T, Nakano K, Tanaka M. Intraductal papillary-mucinous tumor of the pancreas concomitant with ductal carcinoma of the pancreas. Pancreatology. 2002;2:484-0. CrossRef
  4. Tanno S, Nakano Y, Koizumi K, Sugiyama Y, Nakamura K, Sasajima J, et al. Pancreatic ductal adenocarcinomas in long-term follow-up patients with branch duct intraductal papillary mucinous neoplasms. Pancreas. 2010;39:36-0. CrossRef
  5. Tanno S, Nakano Y, Sugiyama Y, Nakamura K, Sasajima J, Koizumi K, et al. Incidence of synchronous and metachronous pancreatic carcinoma in 168 patients with branch duct intraductal papillary mucinous neoplasms. Pancreatology. 2010;10:173-. CrossRef
  6. Sawai Y, Yamao K, Bhatia V, Chiba T, Mizuno N, Sawaki A, et al. Development of pancreatic cancers during long-term follow-up of side-branch intraductal papillary mucinous neoplasms. Endoscopy. 2010;42:1077-4. CrossRef
  7. Ingkakul T, Sadakari Y, Ienaga J, Satoh N, Takahata S, Tanaka M. Predictors of the presence of concomitant invasive ductal carcinoma in intraductal papillary mucinous neoplasm of the pancreas. Ann Surg. 2010;251:70-. CrossRef
  8. Yamaguchi K, Kanemitsu S, Hatori T, Maguchi H, Shimizu Y, Tada M, et al. Pancreatic ductal adenocarcinoma derived from IPMN and pancreatic ductal adenocarcinoma concomitant with IPMN. Pancreas. 2011;40:571-0. CrossRef
  9. Maguchi H, Tanno S, Mizuno N, Hanada K, Kobayashi G, Hatori T, et al. Natural history of branch duct intraductal papillary mucinous neoplasms of the pancreas: a multicenter study in Japan. Pancreas. 2011;40:364-0. CrossRef
  10. Ohtsuka T, Kono H, Tanabe R, Nagayoshi Y, Mori Y, et al. Follow-up study after resection of intraductal papillary mucinous neoplasm of the pancreas; special references to the multifocal lesions and development of ductal carcinoma in the remnant pancreas. Am J Surg 2012;204:44-8.
  11. Tanaka M. Controversies in the management of pancreatic IPMN. Nat Rev Gastroenterol Hepatol. 2011;8:56-0. CrossRef
  12. Fujita N, Noda Y, Kobayashi G, Kimura K, Ito K. Endoscopic approach to early diagnosis of pancreatic cancer. Pancreas. 2004;28:279-1. CrossRef
  13. Ross WA, Wasan SM, Evans DB, Wolff RA, Trapani LV, Staerkel GA, et al. Combined EUS with FNA and ERCP for evaluation of patients with obstructive jaundice from presumed pancreatic malignancy. Gastrointest Endosc. 2008;68:461-. CrossRef
  14. Ogawa Y, Tanaka M, Inoue K, Yamaguchi K, Chijiiwa K, Mizumoto K, et al. A prospective pancreatographic study of the prevalence of pancreatic carcinoma in patients with diabetes mellitus. Cancer. 2002;94:2344-. CrossRef
  15. Inoue K, Ohuchida J, Ohtsuka T, Nabae T, Yokohata K, Ogawa Y, et al. Severe localized stenosis and marked dilation of the main pancreatic duct are indicators of pancreatic cancer instead of chronic pancreatitis on endoscopic retrograde balloon pancreatography. Gastrointest Endosc. 2003;58:510-. CrossRef
  16. McGuire DE, Venu RP, Brown RD, Etzkorn KP, Glaws WR, Abu-Hammour A. Brushing cytology for pancreatic carcinoma: an analysis of factors influencing results. Gastrointest Endosc. 1996;44:300-. CrossRef
  17. Yokohata K, Shirahane K, Yonemasu H, Nabae T, Inoue K, Ohtsuka T, et al. Focal ductal branch dilation on magnetic resonance cholangiopancreatography: a hint for early diagnosis of pancreatic carcinoma. Scand J Gastroenterol. 2000;35:1229-2. CrossRef
  18. Mori Y, Ohtsuka T, Tsutsumi K, Yasui T, Sadakari Y, Ueda J, et al. Multifocal pancreatic ductal adenocarcinoma concomitant with intraductal papillary mucinous neoplasms of the pancreas, detected by intraoperative pancreatic juice cytology: report of a case. JOP. 2010;11:389-2.
  19. Sadakari Y, Ienaga J, Kobayashi K, Miyasaka Y, Takahata S, Nakamura M, et al. Cyst size indicates malignant transformation in branch duct intraductal papillary mucinous neoplasm of the pancreas without mural nodule. Pancreas. 2010;39:232-. CrossRef
  20. Adsay NV, Kloppel G, Fukushima N, Offerhaus GJA, Furukawa T, Pitman MB, et al. Intraductal papillary-mucinous neoplasms of the pancreas. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. World Health Organization classification of tumors, pathology and genetics of tumors of the digestive system. Lyon: IARC Press; 2010. p. 304-3.
  21. Japan Pancreas Society. Classification of pancreatic carcinoma. 2nd ed revised in English. Tokyo: Kanehara; 2002.
  22. Tanaka M, Yokohata K, Konomi H, Yamaguchi K, Chijiiwa K, Ohta M. Segmental balloon cytology for preoperative localization of in situ pancreatic cancer. Gastrointest Endosc. 1997;46:447-. CrossRef
  23. Poon RT, Yeung C, Lo CM, Yuen WK, Liu CL, Fan ST. Prophylactic effect of somatostatin on post-ERCP pancreatitis: a randomized controlled trial. Gastrointest Endosc. 1999;49:593-. CrossRef
  24. Yamaguchi K, Nakamura M, Shirahane K, Kawamoto M, Konomi H, Ohta M, et al. Pancreatic juice cytology in IPMN of the pancreas. Pancreatology. 2005;5:416-1. CrossRef
  25. Inagaki M, Maguchi M, Kino S, Obara M, Ishizaki A, Onodera K, et al. Mucin-producing tumors of the pancreas: clinicopathological features, surgical treatment, and outcome. J Hepatobiliary Pancreat Surg. 1999;6:281-. CrossRef
  26. Ishikawa O, Imaoka S, Ohigashi H, Nakaizumi A, Uehara H, Wada A, et al. A new method of intraoperative cytodiagnosis for more precisely locating the occult neoplasms of the pancreas. Surgery. 1992;111:294-00.
  27. Iiboshi T, Hanada K, Fukuda T, Yonehara S, Sasaki T, Chayama K. Value of cytodiagnosis using endoscopic nasopancreatic drainage for early diagnosis of pancreatic cancer: establishing a new method for the early detection of pancreatic carcinoma in situ. Pancreas. 2012;41:523-. CrossRef
  28. Kikuyama M, Itoi T, Ota Y, Matsuyama K, Tsuchiya T, Itokawa F, et al. Therapeutic endoscopy for stenotic pancreatodigestive tract anastomosis after pancreatoduodenectomy. Gastrointest Endosc. 2012;73:376-2. CrossRef
  
• 作者单位：Takao Ohtsuka (1)
  Noboru Ideno (1)
  Teppei Aso (1)
  Yosuke Nagayoshi (1)
  Hiroshi Kono (1)
  Yasuhisa Mori (1)
  Shunichi Takahata (1)
  Yasunori Oda (2)
  Shinichi Aishima (2)
  Hisato Igarashi (3)
  Tetsuhide Ito (3)
  Kousei Ishigami (4)
  Masafumi Nakamura (1)
  Kazuhiro Mizumoto (1)
  Masao Tanaka (1)
  
  1. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
  2. Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  3. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  4. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  

文摘

Background Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is often found with distinct pancreatic ductal adenocarcinoma (PDAC) in the same pancreas. The aim of this study was to clarify whether endoscopic retrograde pancreatography (ERP) would be useful for the early detection of concomitant PDACs in patients with IPMNs. Methods Medical records of 179 patients who were histologically confirmed to have IPMNs after resection between 1987 and 2011 were reviewed. The patients having concomitant PDACs were selected, and the diagnostic abilities to detect concomitant PDACs of computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasonography (EUS), and ERP were compared between early (stages 0–I according to Japanese General Rules for Pancreatic Cancer) and advanced (stages II–IV) PDACs. Results A total of 23 PDACs developed synchronously or metachronously in 20 patients, and the prevalence of PDACs concomitant with IPMNs was 11.2?% (20/179). Sensitivities of CT (16 vs. 87?%), MRI (29 vs. 93?%), and EUS (29 vs. 92?%) in the early group were significantly lower than those in the advanced group (p?<?0.01). On the other hand, the sensitivity of ERP in the early group was as high as that in the advanced group (86 vs. 82?%, respectively, p?>?0.99). Among 7 early PDACs, 3 were diagnosed only by ERP. Conclusions ERP has an important role in the early diagnosis of distinct PDACs in patients with IPMNs. Further investigation is necessary to clarify the indication and the timing of ERP during management of IPMNs in term of early detection of concomitant PDACs.