Early Detection of Pancreatic Cancer in Patients With Chronic Liver Disease Under Hepatocellular Carcinoma Surveillance
Early Detection of Pancreatic Cancer in Patients With Chronic Liver Disease Under Hepatocellular Carcinoma Surveillance
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DOI：
10.1016/j.mayocp.2018.12.034
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发表时间：
2019-10-01
影响因子：
8.9
通讯作者：
Hiasa, Yoichi
中科院分区：
文献类型：
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作者：
Kumagi, Teru;Terao, Takashi;Hiasa, Yoichi
目的：为了评估在肝细胞癌（HCC）的腹部影像学监测期间，患有B型肝炎病毒（HBV）和丙型肝炎病毒（HCV）相关慢性肝病的患者是否在早期被诊断为胰腺癌（PC）。收集有关HBV和HCV状态、PC诊断可能性和国际癌症控制联盟（UICC）分期的数据。使用卡方检验进行组间比较。HCC监测组（n=16）的UICC分期分布为0期（n=2，12.5%）、IA期（n=3，18.8%）、IB期（n=2，12.5%）、IIA期（n=2，12.5%）、IIB期（n=2，12.5%）、III期（n=1，6.3%）和IV期（n=4，25%）。非监测组（n=431）的UICC分期分布为0期（n=4，0.9%）、IA期（n=28，6.5%）、IB期（n=27，6.3%）、IIA期（n=86，20.0%）、IIB期（n=48，11.1%）、III期（n=56，13.0%）和IV期（n=182，42.2%）。HCC监测组0期患者明显多于IA至IV期患者（P= 0.02）。当包括IA期（P=.007）和IB期（P=.004）作为早期阶段而不是IIA期（P=.10）时，观察到类似的结果。扩张的胰管导致PC诊断在所有6例0期diseases.Conclusion：HBV和HCV相关的慢性肝病患者有早期PC诊断在HCC监测。在HCC监测期间，对胰腺的仔细评估是必要的。(C)2019年马约医学教育和研究基金会。爱思唯尔公司出版
Objective: To evaluate whether patients with hepatitis B virus (HBV)- and hepatitis C virus (HCV)-related chronic liver disease were diagnosed as having pancreatic cancer (PC) at an early stage during abdominal imaging surveillance for hepatocellular carcinoma (HCC).Patients and Methods: We retrospectively examined 447 patients with PC diagnosed at Ehime University Hospital and affiliated centers (2011-2013). Data were collected regarding HBV and HCV status, likelihood of PC diagnosis, and Union for International Cancer Control (UICC) stage. Intergroup comparisons were performed using the chi(2) test.Results: The UICC stage distribution in the HCC surveillance group (n=16) was stage 0 (n=2, 12.5%), stage IA (n=3, 18.8%), stage IB (n=2, 12.5%), stage IIA (n=2, 12.5%), stage IIB (n=2, 12.5%), stage III (n=1, 6.3%), and stage IV (n=4, 25%). The UICC stage distribution in the non-surveillance group (n=431) was stage 0 (n=4, 0.9%), stage IA (n=28, 6.5%), stage IB (n=27, 6.3%), stage IIA (n=86, 20.0%), stage IIB (n=48, 11.1%), stage III (n=56, 13.0%), and stage IV (n=182, 42.2%). The HCC surveillance group had significantly more patients with stage 0 disease than with stages IA through IV (P=.02). Similar results were observed when including stages IA (P=.007) and IB (P=.004) as early stages but not stage IIA (P=.10). A dilated pancreatic duct led to a PC diagnosis in all 6 patients with stage 0 disease.Conclusion: Patients with HBV- and HCV-related chronic liver disease had an early PC diagnosis during HCC surveillance. Careful evaluation of the pancreas is warranted during HCC surveillance. (C) 2019 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc.