Clinical Gastroenterology Vol.31 No.13(4-2)

Theme Diagnostic Strategy for Early Stage Pancreatic Cancer
Title Systematic Approach for the Diagnosis of Pancreatic Cancer in a Curable Stage
Publish Date 2016/12
Author Sachiko Tanaka Osaka Center for Cancer & Cardiovascular Disease Prevention / Osaka Medical Center for Cancer and Cardiovascular Diseases
Author Rena Takakura Osaka Center for Cancer & Cardiovascular Disease Prevention
Author Tetsushi Ishida Osaka Center for Cancer & Cardiovascular Disease Prevention
Author Junko Fukuda Osaka Medical Center for Cancer and Cardiovascular Diseases
Author Miho Nakao Osaka Medical Center for Cancer and Cardiovascular Diseases
Author Tatsuya Ioka Osaka Medical Center for Cancer and Cardiovascular Diseases
[ Summary ] A systematic approach is necessary to detect and diagnose pancreatic cancer in a curable stage. We propose a system composed of four steps. The first step is to screen patients at high risk for pancreatic cancer (such as those with main pancreatic duct dilatation or pancreatic cysts) with screening US examinations. The second step is to perform periodic checkups for high‒risk groups with non‒invasive examinations of the pancreas, such as special US (ultrasonography), focusing on the pancreas. The third step is to detect minor changes such as the appearance of a tiny hypo‒echoic area in the pancreas or in the cyst/pancreatic duct, or increases in the size of cysts or pancreatic duct diameter, and to exclude benign lesions with contrast‒ enhanced US. The fourth step is to make a definite diagnosis of pancreatic cancer with EUS‒FNA (endoscopic ultrasound-guided fine-needle aspiration) and/or ERCP‒PJC (endoscopic retrograde cholangiopancreatography-pancreatic juice cytology).
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