New Screening System Using Forward-Viewing Radial Endoscopic Ultrasound and Magnetic Resonance Imaging for High-Risk Individuals With Familial History of Pancreatic Cancer

Frontiers in Medicine

article

Reiko Ashida¹  Tatsuya Ioka²  Ryoji Takada⁴  Nobuyasu Fukutake⁴  Kenji Ikezawa⁴  Kazuyoshi Ohkawa⁴  Shigenori Nagata⁶  Hidenori Takahashi⁷ 

[1] Second Department of Internal Medicine, Wakayama Medical University;Department of Cancer Survey and Gastrointestinal Oncology, Osaka International Cancer Institute;Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine;Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute;Department of Gastroenterology, Osaka National Hospital;Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute;Department of Surgery, Osaka International Cancer Institute;Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University

关键词: EUS;    pancreatic cancer;    family history;    early chronic pancreatitis;    IPMN;   

DOI  :  10.3389/fmed.2022.928182

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background and Aims Attention is increasingly being paid to family history of pancreatic cancer (PC) as a risk factor for developing PC. It is mandatory to develop a screening system for early detection of PC; however, the relationship between a family history of PC and the incidence of pancreatic abnormalities, such as pancreatic cyst and chronic pancreatitis (CP), in the Japanese population remains unknown. Patients and Methods Individuals with a family history of PC were prospectively enrolled in a screening program using forward-viewing radial endoscopic ultrasound (FR-EUS) and magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) as the diagnostic modalities. Results In total, forty-three individuals in 37 families were enrolled (mean age, 54 years). All individuals underwent FR-EUS and MRI with no complications. FR-EUS revealed resectable PC ( n = 1, 2.3%), pancreatic cysts ( n = 24, 55.8%), intraductal papillary mucinous neoplasm (IPMN; n = 13, 30.2%), and early CP-like appearance ( n = 15, 34.9%). The detection rate of early CP-like appearance was significantly higher by EUS than by MRI. Pancreatic cysts and IPMN detected by FR-EUS were significantly correlated to age (≥60 years) and less correlated to men (hazard ratio [HR] 22.4; 95% confidence interval [CI], 2.10–236.0; p < 0.01 and HR 0.092; 95% CI, 0.01–0.83; p = 0.033, respectively). Early CP-like appearance detected by FR-EUS was significantly correlated with men and smoking (HR 5.0; 95% CI, 1.3–19.3; p = 0.02 and HR 4.02; 95% CI, 0.991–16.3; p = 0.05, respectively). Conclusion A screening system using FR-EUS and MRI/MRCP for individuals with a family history of PC was useful for identifying curable PC and pancreatic abnormalities. The incidence of pancreatic cysts, such as IPMN and early CP-like appearance, was also high in the Japanese cohort.

【 授权许可】

CC BY