| セッション情報 | The 4th International ForumII Challenge to the pancreatic and biliary cancers 2. Pancreatic cancer―Challenge to the early detection |
|---|---|
| タイトル | IFII-2-3：Diagnostic strategies for the early diagnosis of pancreatic cancer |
| 演者 | Hanada Keiji（Department of Gastroenterology, Onomichi General Hospital, Japan） |
| 共同演者 | Iiboshi Tomohiro（Department of Gastroenterology, Onomichi General Hospital, Japan） |
| 抄録 | Detection of pancreatic cancer（PC）at an early stage with curative surgery is the approach with the potential to significantly improve long-term patient outcome. However, the rate of tumor detection of computed tomography（CT）in the case with small pancreatic cancer was not satisfied. For the diagnoses of PC less than 10mm, the rate of tumor detection was higher for endoscopic ultrasonography（EUS）than for CT or other modalities, and the histologic diagnosis with EUS guided fine needle aspiration（EUS-FNA）was helpful in confirming the diagnosis. For the diagnosis of PC in situ, EUS and magnetic resonance pancreatocholangiography（MRCP）played important roles in detecting of the local irregular stenosis of the pancreatic duct. Endoscopic retrograde pancreatography（ERP）and sequential cytodiagnosis of pancreatic juice using endoscopic nasopancreatic drainage（ENPD）multiple times were useful in the diagnosis of PC in situ. In 2007, Onomichi Medical Association tried to start a social program for diagnosis of the small pancreatic cancer. Specialized doctors for pancreatic cancer（SDPC）in medical centers enlightened practicing doctors about risk factors of PC, abnormal findings of US, or elevated serum pancreatic enzymes. Simultaneously, if practicing doctors experienced the patient with these previous problems, they aggressively consulted SDPC each other. From January 2007 to June 2013, a total of 4969 cases were consulted with SDPC in Onomichi General Hospital. Methods of image diagnosis of CT, MRI, and EUS were performed in 4157, 2303, and 1692. Among these cases, ERP was performed in 550 cases. ENPD and the repeated cytology using pancreatic juice were performed in 59. EUS-FNA was performed in 257. As a result, 338 cases were proved as adenocarcinoma histocytologically. There were 13 cases with stage 0, and 28 cases with stage Ia histopathologically. To detect of early stage of PC, the relationship between SDPC in medical centers and practicing doctors is very important. ENPD and repeated cytology using pancreatic juice also may play important roles in diagnosis of the early stage of PC. |
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