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Endoscopic Ultrasound Can Differentiate High-Grade Pancreatic Intraepithelial Neoplasia, Small Pancreatic Ductal Adenocarcinoma, and Benign Stenosis.
Sagami, Ryota; Yamao, Kentaro; Minami, Ryuki; Nakahodo, Jun; Akiyama, Hidetoshi; Nishikiori, Hidefumi; Mizukami, Kazuhiro; Yamao, Kenji; Bhatia, Vikram; Amano, Yuji; Murakami, Kazunari.
Afiliação
  • Sagami R; Department of Gastroenterology, Oita San-ai Medical Center, Oita, Japan.
  • Yamao K; Pancreatic Cancer Research for Secure Salvage Young Investigators (PASSYON), Osaka-Sayama, Japan.
  • Minami R; Pancreatic Cancer Research for Secure Salvage Young Investigators (PASSYON), Osaka-Sayama, Japan.
  • Nakahodo J; Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
  • Akiyama H; Pancreatic Cancer Research for Secure Salvage Young Investigators (PASSYON), Osaka-Sayama, Japan.
  • Nishikiori H; Department of Gastroenterology, Tenri Hospital, Nara, Japan.
  • Mizukami K; Pancreatic Cancer Research for Secure Salvage Young Investigators (PASSYON), Osaka-Sayama, Japan.
  • Yamao K; Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan.
  • Bhatia V; Department of Gastroenterology, Oita Red Cross Hospital, Oita, Japan.
  • Amano Y; Department of Gastroenterology, Oita San-ai Medical Center, Oita, Japan.
  • Murakami K; Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan.
Gut Liver ; 18(2): 338-347, 2024 Mar 15.
Article em En | MEDLINE | ID: mdl-37165770
Background/Aims: High-grade pancreatic intraepithelial neoplasia and invasive pancreatic ductal adenocarcinoma ≤10 mm are targets for early detection of pancreatic cancer. However, their imaging characteristics are unknown. We aimed to identify endoscopic ultrasound findings for the detection of these lesions. Methods: Patients diagnosed with high-grade pancreatic intraepithelial neoplasia (n=29), pancreatic ductal adenocarcinoma ≤10 mm (n=11) (who underwent surgical resection), or benign main pancreatic duct stenosis (n=20) between January 2014 and January 2021 were retrospectively included. Six features differentiating these lesions were examined by endoscopic ultrasonography: main pancreatic duct stenosis, upstream main pancreatic duct dilation, hypoechoic areas surrounding the main pancreatic duct irregularities (mottled areas without demarcation or round areas with demarcation), branch duct dilation, prominent lobular segmentation, and atrophy. Interobserver agreement was assessed by two independent observers. Results: Hypoechoic areas surrounding the main pancreatic duct irregularities were observed more frequently in high-grade pancreatic intraepithelial neoplasia (82.8%) and pancreatic ductal adenocarcinoma ≤10 mm (90.9%) than in benign stenosis (15.0%) (p<0.001). High-grade pancreatic intraepithelial neoplasia exhibited mottled hypoechoic areas more frequently (79.3% vs 18.9%, p<0.001), and round hypoechoic areas less frequently (3.4% vs 72.7%, p<0.001), than pancreatic ductal adenocarcinoma ≤10 mm. The sensitivity and specificity of hypoechoic areas for differentiating high-grade pancreatic intraepithelial neoplasia, pancreatic ductal adenocarcinoma ≤10 mm, and benign stenosis were both 85.0%, with moderate interobserver agreement. Conclusions: The hypoechoic areas surrounding main pancreatic duct irregularities on endoscopic ultrasound may differentiate between high-grade pancreatic intraepithelial neoplasia, pancreatic ductal adenocarcinoma ≤10 mm, and benign stenosis (Trial Registration: UMIN Clinical Trials Registry (UMIN000044789).
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Carcinoma in Situ / Carcinoma Ductal Pancreático Tipo de estudo: Prognostic_studies / Screening_studies Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Carcinoma in Situ / Carcinoma Ductal Pancreático Tipo de estudo: Prognostic_studies / Screening_studies Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article