Multicenter study of early pancreatic cancer in Japan
Multicenter study of early pancreatic cancer in Japan
复制标题
DOI：
10.1016/j.pan.2017.11.007
复制
发表时间：
2018-01-01
期刊：
影响因子：
3.6
通讯作者：
Shimosegawa, Tooru
中科院分区：
文献类型：
--
作者：
Kanno, Atsushi;Masamune, Atsushi;Shimosegawa, Tooru
背景/目的：早期胰腺导管腺癌（PDAC）的诊断仍然具有挑战性。我们在日本进行了一项多中心研究，以阐明早期PDAC的临床特征。方法：根据日本第六版胰腺癌分类，收集0期和I期PDAC患者。我们回顾性分析了临床资料，包括医学检查的机会，成像方式和结果，细胞学诊断方法，以及根据诊断阶段的预后。结果：报告了来自14家机构的200例0期和I期PDAC，分别约占所有PDAC病例的0.7%和3%。总体而言，20%的早期PDAC病例有症状。间接影像学表现如主胰管扩张对早期PDAC的检测是有用的。特别是，局部脂肪变化可能是早期PDAC所特有的。术前病理诊断，内镜逆行胰胆管造影时细胞学检查比超声细针穿刺更常用。虽然总体预后良好，但11.5%的病例在残余胰腺中出现新的PDAC病变。结论：这项多中心研究揭示了早期PDAC的诊断和治疗的几个关键点，包括无症状病例的筛选、间接影像学发现的重要性、内镜逆行胰胆管造影中细胞学的应用以及残余胰腺癌变的风险。（三）2017年IAP和EPC。Elsevier B.V.版权所有。
Background/Objectives: The diagnosis of early-stage pancreatic ductal adenocarcinoma (PDAC) is still challenging. We conducted a multicenter study to clarify the clinical features of early-stage PDAC in Japan.Methods: We collected patients with stage 0 and stage I PDAC according to the sixth edition of the Japanese Classification of Pancreatic Carcinoma. We retrospectively analyzed the clinical profiles including opportunities for medical examination, imaging modalities and findings, methods of cytological diagnosis, and prognosis according to the stages at diagnosis.Results: Two hundred cases with Stage 0 and stage I PDAC were reported from 14 institutions, which accounted for approximately 0.7% and 3% of all PDAC cases, respectively. Overall, 20% of the early-stage PDAC cases were symptomatic. Indirect imaging findings such as dilatation of the main pancreatic duct were useful to detect early-stage PDAC. In particular, local fatty changes may be specific to early-stage PDAC. For preoperative pathologic diagnosis, cytology during endoscopic retrograde cholangiopancreatography was more commonly applied than endoscopic ultrasound fine-needle aspiration. Although the overall prognosis was favorable, new PDAC lesions developed in the remnant pancreas in 11.5% cases.Conclusions: This multicenter study revealed several key points concerning the diagnosis and management of early-stage PDAC, including screening of asymptomatic cases, importance of indirect imaging findings, application of cytology during endoscopic retrograde cholangiopancreatography, and the risk of carcinogenesis in the remnant pancreas. (C) 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved.