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Efficacy of repeated cytology of pancreatic juice obtained by endoscopic nasopancreatic drainage tube for early diagnosis of pancreatic cancer: a case series including a case of carcinoma in situ

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Abstract

Repeated cytology of pancreatic juice obtained by endoscopic nasopancreatic drainage (ENPD) tube has been highlighted as an early diagnostic method for small pancreatic cancer, including carcinoma in situ. We report two cases of early-stage pancreatic cancer diagnosed using repeated cytology; both cases underwent curative resection. No significant masses were found on conventional imaging in either case, with only pancreatic duct strictures being observed. ENPD tubes were placed to collect pancreatic juice in both cases. In case 1, two of five pancreatic juice samples showed adenocarcinoma. Therefore, distal pancreatectomy was performed, and a PanIN3 grade neoplasm (carcinoma in situ) was identified at the branch duct near the distal stricture. In case 2, two of seven pancreatic juice samples (collected during the second tube placement) showed adenocarcinoma. Therefore, distal pancreatectomy was performed, and a PanIN3 neoplasm was identified primarily in the pancreatic duct at a narrow section with fibrosis. Partial microinvasion (<1 mm) was observed at the branch duct. Repeated cytology of pancreatic juice obtained by ENPD tube is effective for early diagnosis of pancreatic cancer, especially in cases without mass formation. However, some issues, including the appropriate number of samples, should be addressed in large prospective studies.

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Authors and Affiliations

  1. Department of Gastroenterology, Okinawa Prefectural Chubu Hospital, 281 Miyazato, Uruma, Okinawa, 904-2293, Japan

    Shin Kato, Moriya Zakimi, Koki Yamada, Kenji Chinen, Tomiaki Kubota, Masayuki Arashiro & Kaoru Kikuchi

  2. Department of Surgery, Okinawa Prefectural Chubu Hospital, Uruma, Okinawa, Japan

    Takahiro Murakami

  3. Department of Pathology, Okinawa Prefectural Chubu Hospital, Uruma, Okinawa, Japan

    Fumihito Kunishima

Authors
  1. Shin Kato
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  2. Moriya Zakimi
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  3. Koki Yamada
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  4. Kenji Chinen
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  5. Tomiaki Kubota
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  6. Masayuki Arashiro
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  7. Kaoru Kikuchi
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  9. Fumihito Kunishima
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Correspondence to Shin Kato.

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All authors declare that they have no conflict of interest.

Human/Animal Rights:

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).

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Informed consent was obtained from all patients for being included in the study.

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Kato, S., Zakimi, M., Yamada, K. et al. Efficacy of repeated cytology of pancreatic juice obtained by endoscopic nasopancreatic drainage tube for early diagnosis of pancreatic cancer: a case series including a case of carcinoma in situ. Clin J Gastroenterol 8, 240–246 (2015). https://doi.org/10.1007/s12328-015-0587-6

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  • DOI: https://doi.org/10.1007/s12328-015-0587-6

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