Special Issue "Early Diagnosis of Pancreatic Cancer"

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging".

Deadline for manuscript submissions: 28 June 2019

Special Issue Editors

Guest Editor
Dr. Masataka Kikuyama

Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
Website | E-Mail
Interests: pancreatic cancer; EUS; EUS-FNA; ERCP; endoscopic intervention; biliary stent; pancreatic stent; nasopancreatic drainage; pancreatic juice cytology; SPACE
Guest Editor
Prof. Masayuki Kitano

Deparment of Gastroenterology, Wakayama Medical University, Wakayama 641-8509, Japan
E-Mail
Interests: EUS, CE-EUS, EUS-FNA, pancreatic cancer, early diagnosis, IPMN

Special Issue Information

Dear Colleagues,

Pancreatic cancer (PC) has a poor prognosis, because the diagnosis of PC is delayed. To improve the poor prognosis, early diagnosis is needed. For early diagnosis of PC, patients with clinical manifestations suggestive of PC and high risks for developing PC need to be selected for examination for PC. The signs suggestive of PC, such as abdominal symptoms, DM onset, or acute pancreatitis should not be missed, and the detail of risks for PC including IPMN, chronic pancreatitis, or heredity of PC should be understood. For diagnosing PC, computed tomography (MDCT), magnetic resonance imaging (MRI), and positron emission tomography (PET) could be selected, while the diagnostic ability of these examinations for early stage PC is limited. Recently, endoscopic diagnostic procedures, such as endoscopic ultrasonography, including fine-needle aspiration has been widely accepted for diagnosing PC, including small PC, and endoscopic retrograde pancreatocholangiography using serial pancreatic-juice aspiration cytologic examination (SPACE) has been developed for a detailed examination to diagnose earlier pancreatic cancer, including carcinoma in situ.

Dr. Masataka Kikuyama
Prof. Masayuki Kitano
Guest Editors

Manuscript Submission Information

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Keywords

  • Pancreatic cancer
  • Early diagnosis
  • IPMN
  • Acute pancreatitis
  • Chronic pancreatitis
  • DM
  • Heredity
  • CT
  • MRI
  • PET
  • EUS
  • ERCP
  • SPACE

Published Papers (4 papers)

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Research

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Open AccessArticle
Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic Cancer
Diagnostics 2019, 9(1), 15; https://doi.org/10.3390/diagnostics9010015
Received: 28 November 2018 / Revised: 18 January 2019 / Accepted: 18 January 2019 / Published: 23 January 2019
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Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Early Diagnosis of Pancreatic Cancer)
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Review

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Open AccessReview
Roles of ERCP in the Early Diagnosis of Pancreatic Cancer
Diagnostics 2019, 9(1), 30; https://doi.org/10.3390/diagnostics9010030
Received: 18 January 2019 / Revised: 4 March 2019 / Accepted: 5 March 2019 / Published: 7 March 2019
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Abstract
It has been reported that endoscopic retrograde cholangiopancreatography (ERCP) is of value in evaluating precise pancreatograms of the pancreatic duct (PD). Recently, institutions have tended to perform magnetic resonance cholangiopancreatography (MRCP) for the diagnosis of PD due to post-ERCP pancreatitis (PEP). In small [...] Read more.
It has been reported that endoscopic retrograde cholangiopancreatography (ERCP) is of value in evaluating precise pancreatograms of the pancreatic duct (PD). Recently, institutions have tended to perform magnetic resonance cholangiopancreatography (MRCP) for the diagnosis of PD due to post-ERCP pancreatitis (PEP). In small pancreatic cancer (PC), including PC in situ (PCIS) which is undetectable on cross sectional images, endoscopic ultrasonography (EUS) and MRCP serve important roles in detecting local irregular stenosis of the PD or small cystic lesions. Subsequently, ERCP and associated serial pancreatic juice aspiration cytologic examination (SPACE) obtained by endoscopic nasopancreatic drainage (ENPD) may be useful in the diagnosis of very early-stage PC. Further prospective multicenter studies are required to establish a standard method of SPACE for the early diagnosis of PC. Full article
(This article belongs to the Special Issue Early Diagnosis of Pancreatic Cancer)
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Open AccessReview
Advances in Early Detection of Pancreatic Cancer
Diagnostics 2019, 9(1), 18; https://doi.org/10.3390/diagnostics9010018
Received: 10 January 2019 / Revised: 24 January 2019 / Accepted: 28 January 2019 / Published: 5 February 2019
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Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease. PDAC is the fourth leading cause of death in the United States and Japan based on epidemiological data. Early detection of PDAC is very important to improve the prognosis of PDAC. Early detection of pancreatic [...] Read more.
Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease. PDAC is the fourth leading cause of death in the United States and Japan based on epidemiological data. Early detection of PDAC is very important to improve the prognosis of PDAC. Early detection of pancreatic ductal adenocarcinoma (PDAC) requires further examination after selecting cases with risk factors for the condition, such as family history, hereditary pancreatic carcinoma syndrome, intraductal papillary mucinous neoplasms, or chronic pancreatitis. The Japan Study Group on the Early Detection of Pancreatic Cancer has investigated and clarified the clinicopathological features for the early diagnosis of PDAC. In Japan, an algorithm for the early diagnosis of PDAC, which utilized the cooperation of local clinics and regional general hospitals, has been a breakthrough in the detection of early-stage PDAC. Further approaches for the early diagnosis of PDAC are warranted. Full article
(This article belongs to the Special Issue Early Diagnosis of Pancreatic Cancer)
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Open AccessReview
The Role of Transabdominal Ultrasound in the Diagnosis of Early Stage Pancreatic Cancer: Review and Single-Center Experience
Received: 28 November 2018 / Revised: 20 December 2018 / Accepted: 23 December 2018 / Published: 26 December 2018
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Abstract
Pancreatic cancer (PC) is the fourth leading cause of cancer-related death with a 5-year survival rate less than 10%. In the absence of effective screening methods, such as blood markers, most clinical diagnoses of PC are made at an advanced stage. However, early [...] Read more.
Pancreatic cancer (PC) is the fourth leading cause of cancer-related death with a 5-year survival rate less than 10%. In the absence of effective screening methods, such as blood markers, most clinical diagnoses of PC are made at an advanced stage. However, early stage PC is associated with a more favorable five-year survival rate of 85.8% for stage 0, and 68.7% for stage IA. Transabdominal ultrasound (US) is frequently used as a first-line diagnostic tool in the clinical setting and a preferred modality for routine medical evaluations for asymptomatic individuals. Recently published Japanese data show that most PCs diagnosed in early stage had US findings, such as dilated main pancreatic ducts or pancreas cysts. For surveillance of high-risk individuals, such as those with an intraductal papillary mucinous neoplasm (IPMN), US is an ideal modality in terms of its non-invasive and cost-effective nature. However, the diagnostic performance of ultrasound varies greatly by the operator’s experience and the patient’s condition. This article reviews the present situation of early diagnosis of pancreatic cancer by US, along with tips for improving visualization of the pancreas. Full article
(This article belongs to the Special Issue Early Diagnosis of Pancreatic Cancer)
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