| Theme |
Diagnostic Strategy for Early Stage Pancreatic Cancer |
| Title |
ERCP for Diagnosis of Early Pancreatic Cancer |
| Author |
Hideaki Koga |
Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author |
Hiroyuki Maguchi |
Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author |
Akio Katanuma |
Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author |
Kei Yane |
Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author |
Toshifumi Kin |
Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author |
Kuniyuki Takahashi |
Center for Gastroenterology, Teine‒Keijinkai Hospital |
| [ Summary ] |
It is important to diagnose pancreatic cancer (PC) in its early stage owing to its poor prognosis. Indications for endoscopic retrograde cholangiopancreatography (ERCP) for diagnosing early PC are a localized main pancreatic duct (MPD) stricture, small pancreatic mass affecting the MPD or a pancreatic mass which was failed diagnosing PC by EUS-FNA. ERCP findings of Stage I PC are an irregular stricture of the MPD or branch duct, abrupt stricture with distal MPD dilatation, or MPD narrowing with rigidity. However, Stage 0 PC shows various shapes of MPD stricture. Its strictures have no rigidity and distal MPD dilatation is mild. Therefore, it is often difficult to differentiate between Stage 0 PC and benign MPD strictures. Recently, it has been reported that many small PCs and carcinoma in situ (CIS) lesions derive from the epithelia of branch ducts, and small PCs often have intraepithelial tumor spread. Therefore, pancreatic juice cytology through endoscopic naso‒pancreatic drainage (ENPD) is needed for diagnosing early stage PC, especially Stage 0 (CIS). Placing the tip of the ENPD beyond the MPD stricture and performing multiple pancreatic juice cytology using ENPD is important in increasing the diagnostic accuracy. |