Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic Cancer
Backgrounds: Endoscopic ultrasonography (EUS) is used to observe the stricture of the main pancreatic duct (MPD) and in diagnosing pancreatic cancer (PC). We investigate the findings on EUS by referring to the histopathological findings of resected specimens. Materials and Methods: Six patients with...
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MDPI AG
2019-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/9/1/15 |
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| author | Shuzo Terada Masataka Kikuyama Shinya Kawaguchi Hideyuki Kanemoto Yoshihiro Yokoi Terumi Kamisawa Sawako Kuruma Kazuro Chiba Goro Honda Shinichiro Horiguchi Jun Nakahodo |
| author_facet | Shuzo Terada Masataka Kikuyama Shinya Kawaguchi Hideyuki Kanemoto Yoshihiro Yokoi Terumi Kamisawa Sawako Kuruma Kazuro Chiba Goro Honda Shinichiro Horiguchi Jun Nakahodo |
| author_sort | Shuzo Terada |
| collection | DOAJ |
| description | Backgrounds: Endoscopic ultrasonography (EUS) is used to observe the stricture of the main pancreatic duct (MPD) and in diagnosing pancreatic cancer (PC). We investigate the findings on EUS by referring to the histopathological findings of resected specimens. Materials and Methods: Six patients with carcinoma in situ (CIS) and 30 patients with invasive carcinoma of 20 mm or less were included. The preoperative EUS findings were classified as follows. A1: Simple stricture type—no findings around the stricture; A2: Hypoecho stricture type—localized hypoechoic area without demarcation around the stricture; A3: Tumor stricture type—tumor on the stricture; B: Dilation type—the dilation of the pancreatic duct without a downstream stricture; C: Parenchymal tumor type—tumor located apart from the MPD. Results: Classes A1 and A2 consisted of 2 CISs, and 4 invasive carcinomas included two cases smaller than 5 mm in diameter. Most of the cancers classified as A3 or C were of invasive carcinoma larger than 5 mm in diameter. All cancers classified as B involved CIS. Serial pancreatic-juice aspiration cytologic examination (SPACE) was selected for all types of cases, with a sensitivity of 92.0%, while EUS-guided fine needle aspiration cytology (EUS-FNA) was only useful for invasive carcinoma, and its sensitivity was 66.7%. Conclusions: Stricture without a tumor could be a finding for invasive PC and pancreatic duct dilation without a downstream stricture could be a finding indicative of CIS. Carcinoma smaller than 5 mm in diameter could not be recognized by EUS. SPACE had a high sensitivity for diagnosing small PC. |
| first_indexed | 2024-04-11T13:02:15Z |
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| id | doaj.art-fcb35a93fbe4455cb7dce897690b19f2 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-04-11T13:02:15Z |
| publishDate | 2019-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-fcb35a93fbe4455cb7dce897690b19f22022-12-22T04:22:54ZengMDPI AGDiagnostics2075-44182019-01-01911510.3390/diagnostics9010015diagnostics9010015Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic CancerShuzo Terada0Masataka Kikuyama1Shinya Kawaguchi2Hideyuki Kanemoto3Yoshihiro Yokoi4Terumi Kamisawa5Sawako Kuruma6Kazuro Chiba7Goro Honda8Shinichiro Horiguchi9Jun Nakahodo10Department of Gastroenterology, Shizuoka General Hospital, Shizuoka 420-8527, JapanDepartment of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-0021, JapanDepartment of Gastroenterology, Shizuoka General Hospital, Shizuoka 420-8527, JapanDepartment of Surgery, Shizuoka General Hospital, Shizuoka 420-8527, JapanDepartment of Surgery, Shinshiro Municipal Hospital, Aichi 441-1387, JapanDepartment of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-0021, JapanDepartment of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-0021, JapanDepartment of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-0021, JapanDepartment of Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113-0021, JapanDepartment of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113-0021, JapanDepartment of Human Pathology, Juntendo University, Tokyo 113-8421, JapanBackgrounds: Endoscopic ultrasonography (EUS) is used to observe the stricture of the main pancreatic duct (MPD) and in diagnosing pancreatic cancer (PC). We investigate the findings on EUS by referring to the histopathological findings of resected specimens. Materials and Methods: Six patients with carcinoma in situ (CIS) and 30 patients with invasive carcinoma of 20 mm or less were included. The preoperative EUS findings were classified as follows. A1: Simple stricture type—no findings around the stricture; A2: Hypoecho stricture type—localized hypoechoic area without demarcation around the stricture; A3: Tumor stricture type—tumor on the stricture; B: Dilation type—the dilation of the pancreatic duct without a downstream stricture; C: Parenchymal tumor type—tumor located apart from the MPD. Results: Classes A1 and A2 consisted of 2 CISs, and 4 invasive carcinomas included two cases smaller than 5 mm in diameter. Most of the cancers classified as A3 or C were of invasive carcinoma larger than 5 mm in diameter. All cancers classified as B involved CIS. Serial pancreatic-juice aspiration cytologic examination (SPACE) was selected for all types of cases, with a sensitivity of 92.0%, while EUS-guided fine needle aspiration cytology (EUS-FNA) was only useful for invasive carcinoma, and its sensitivity was 66.7%. Conclusions: Stricture without a tumor could be a finding for invasive PC and pancreatic duct dilation without a downstream stricture could be a finding indicative of CIS. Carcinoma smaller than 5 mm in diameter could not be recognized by EUS. SPACE had a high sensitivity for diagnosing small PC.https://www.mdpi.com/2075-4418/9/1/15pancreatic cancersmall pancreatic cancerearly diagnosiscarcinoma in situ (CIS), endoscopic ultrasonography (EUS), serial pancreatic-juice aspiration cytologic examinationSPACE |
| spellingShingle | Shuzo Terada Masataka Kikuyama Shinya Kawaguchi Hideyuki Kanemoto Yoshihiro Yokoi Terumi Kamisawa Sawako Kuruma Kazuro Chiba Goro Honda Shinichiro Horiguchi Jun Nakahodo Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic Cancer Diagnostics pancreatic cancer small pancreatic cancer early diagnosis carcinoma in situ (CIS), endoscopic ultrasonography (EUS), serial pancreatic-juice aspiration cytologic examination SPACE |
| title | Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic Cancer |
| title_full | Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic Cancer |
| title_fullStr | Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic Cancer |
| title_full_unstemmed | Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic Cancer |
| title_short | Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic Cancer |
| title_sort | proposal for endoscopic ultrasonography classification for small pancreatic cancer |
| topic | pancreatic cancer small pancreatic cancer early diagnosis carcinoma in situ (CIS), endoscopic ultrasonography (EUS), serial pancreatic-juice aspiration cytologic examination SPACE |
| url | https://www.mdpi.com/2075-4418/9/1/15 |
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