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

Ohtsuka Takao, Noboru Ideno, Teppei Aso, Yosuke Nagayoshi, Hiroshi Kono, Yasuhisa Mori, Shunichi Takahata, Yasunori Oda, Shinichi Aishima, Hisato Igarashi, Tetsuhide Ito, Kosei Ishigami, Masafumi Nakamura, Kazuhiro Mizumoto, Masao Tanaka

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29 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)356-361
Number of pages6
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume20
Issue number3
DOIs
Publication statusPublished - Mar 1 2013

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Pancreatic Neoplasms
Adenocarcinoma
Endosonography
Tomography
Magnetic Resonance Imaging
Medical Records
Early Diagnosis
Pancreas

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Role of endoscopic retrograde pancreatography for early detection of pancreatic ductal adenocarcinoma concomitant with intraductal papillary mucinous neoplasm of the pancreas. / Takao, Ohtsuka; Ideno, Noboru; Aso, Teppei; Nagayoshi, Yosuke; Kono, Hiroshi; Mori, Yasuhisa; Takahata, Shunichi; Oda, Yasunori; Aishima, Shinichi; Igarashi, Hisato; Ito, Tetsuhide; Ishigami, Kosei; Nakamura, Masafumi; Mizumoto, Kazuhiro; Tanaka, Masao.

In: Journal of Hepato-Biliary-Pancreatic Sciences, Vol. 20, No. 3, 01.03.2013, p. 356-361.

Research output: Contribution to journalArticle

Takao, Ohtsuka ; Ideno, Noboru ; Aso, Teppei ; Nagayoshi, Yosuke ; Kono, Hiroshi ; Mori, Yasuhisa ; Takahata, Shunichi ; Oda, Yasunori ; Aishima, Shinichi ; Igarashi, Hisato ; Ito, Tetsuhide ; Ishigami, Kosei ; Nakamura, Masafumi ; Mizumoto, Kazuhiro ; Tanaka, Masao. / Role of endoscopic retrograde pancreatography for early detection of pancreatic ductal adenocarcinoma concomitant with intraductal papillary mucinous neoplasm of the pancreas. In: Journal of Hepato-Biliary-Pancreatic Sciences. 2013 ; Vol. 20, No. 3. pp. 356-361.
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title = "Role of endoscopic retrograde pancreatography for early detection of pancreatic ductal adenocarcinoma concomitant with intraductal papillary mucinous neoplasm of the pancreas",
abstract = "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.",
author = "Ohtsuka Takao and Noboru Ideno and Teppei Aso and Yosuke Nagayoshi and Hiroshi Kono and Yasuhisa Mori and Shunichi Takahata and Yasunori Oda and Shinichi Aishima and Hisato Igarashi and Tetsuhide Ito and Kosei Ishigami and Masafumi Nakamura and Kazuhiro Mizumoto and Masao Tanaka",
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T1 - Role of endoscopic retrograde pancreatography for early detection of pancreatic ductal adenocarcinoma concomitant with intraductal papillary mucinous neoplasm of the pancreas

AU - Takao, Ohtsuka

AU - Ideno, Noboru

AU - Aso, Teppei

AU - Nagayoshi, Yosuke

AU - Kono, Hiroshi

AU - Mori, Yasuhisa

AU - Takahata, Shunichi

AU - Oda, Yasunori

AU - Aishima, Shinichi

AU - Igarashi, Hisato

AU - Ito, Tetsuhide

AU - Ishigami, Kosei

AU - Nakamura, Masafumi

AU - Mizumoto, Kazuhiro

AU - Tanaka, Masao

PY - 2013/3/1

Y1 - 2013/3/1

N2 - 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.

AB - 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.

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