PANCREATIC CYSTIC LESIONS: DOCTOR, DO I HAVE PANCREATIC CANCER!?

2020 ◽  
Author(s):  
E Rinja ◽  
V Sandru ◽  
R Plescuta ◽  
A Butuc ◽  
D Vascu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cystic Lesions

Risk independence for the identification of cystic lesions in Familial Pancreatic Cancer (FPC) kindreds

Pancreatology ◽  
2017 ◽  
Vol 17 (3) ◽  
pp. S68
Author(s):  
Andrea Sheel ◽  
Sara Harrison ◽  
Ioannis Sarantitis ◽  
James Nicholson ◽  
Christopher Halloran ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Familial Pancreatic Cancer ◽  
Cystic Lesions

scholarly journals The Screening and Early Detection of Pancreatic Cancer: Who, When, and How?

2020 ◽  
Vol 25 (2) ◽  
pp. 65-71
Author(s):  
Jae Hyuck Chang
Keyword(s):  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
General Population ◽  
Early Detection ◽  
Imaging Modality ◽  
Ductal Adenocarcinoma ◽  
Average Risk ◽  
Cystic Lesions ◽  
Low Prevalence ◽  
New Onset

More than 80% of patients with pancreatic ductal adenocarcinoma (PDA) present with symptomatic, surgically unresectable disease. If a “stage shift” from the current 20% resectable proportion to greater by early detection can be achieved, it will unequivocally lead to improved survival in this otherwise dismal disease. Although the goal of early detection of PDA is laudable, the relatively low prevalence PDA renders general population screening infeasible. To avoid the perils of overdiagnosis and to focus early detection efforts on individuals deemed to be at higher-than-average risk, we need to define those subsets of individuals, such as familial kindred and patients with precursor cystic lesions, chronic pancreatitis, and new-onset diabetes. The next step is to determine when and how often to conduct surveillance in the atrisk individuals and the modalities (biomarkers and imaging) that will be used in the surveillance and diagnostic settings, respectively. Nonetheless, vast challenges still remain in terms of validated blood-based biomarkers, imaging modality, and when and how often the surveillance.

The Incidence and Risk Factor for Pancreatic Cancer in Patients with Pancreatic Cystic Lesions

2017 ◽  
Vol 152 (5) ◽  
pp. S149
Author(s):  
Teppei Yoshioka ◽  
Minoru Shigekawa ◽  
Tomohide Tatsumi ◽  
Hironari Sueyoshi ◽  
Takuo Yamai ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Risk Factor ◽  
Cystic Lesions

Risk of Pancreatic Cancer in Patients with Cystic Lesions of the Pancreas Based upon EUS Morphology

2013 ◽  
Vol 108 ◽  
pp. S91-S92
Author(s):  
Robert Lawson ◽  
Thomas Savides ◽  
Wilson Kwong ◽  
Gordon Hunt ◽  
Andrew Giap
Keyword(s):  
Pancreatic Cancer ◽  
Cystic Lesions

scholarly journals Mo1373 – Is There an Association Between Previously-Identified Pancreatic Cystic Lesions and Subsequent Development of Pancreatic Cancer?

2019 ◽  
Vol 156 (6) ◽  
pp. S-756
Author(s):  
Carine Bou-Abboud Matta ◽  
Jacob Sadik ◽  
Amitabh Chak ◽  
Gregory S. Cooper ◽  
Zachary L. Smith ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Subsequent Development ◽  
Cystic Lesions

scholarly journals Highly Accurate Identification of Cystic Precursor Lesions of Pancreatic Cancer Through Targeted Mass Spectrometry: A Phase IIc Diagnostic Study

2018 ◽  
Vol 36 (4) ◽  
pp. 367-375 ◽  
Author(s):  
Karolina S. Jabbar ◽  
Liisa Arike ◽  
Caroline S. Verbeke ◽  
Riadh Sadik ◽  
Gunnar C. Hansson
Keyword(s):  
Mass Spectrometry ◽  
Pancreatic Cancer ◽  
Carcinoembryonic Antigen ◽  
Validation Cohort ◽  
Malignant Potential ◽  
Cyst Fluid ◽  
High Grade Dysplasia ◽  
High Grade ◽  
Cystic Lesions ◽  
Accurate Identification

Purpose Pancreatic cystic lesions are common incidental findings on imaging, but up to half may be forerunners of pancreatic cancer. Therefore, accurate differential diagnosis is crucial for correct patient management. Unfortunately, currently available diagnostic methods cannot robustly identify premalignant and malignant pancreatic cystic lesions. Methods Cyst fluid samples obtained by routine endoscopic ultrasound-guided aspiration were used for the analyses. In a cohort of 24 patients, eight biomarker candidates for malignant potential and high-grade dysplasia/cancer were identified by an explorative proteomic approach. Subsequently, a quantitative analysis, using 30 heavy-labeled peptides from the biomarkers and parallel reaction monitoring mass spectrometry, was devised, tested in a training cohort of 80, and prospectively evaluated in a validation cohort of 68 patients. End points were surgical pathology diagnosis/clinical follow-up. Diagnostic assessments were blinded to mass spectrometry results. Results The optimal set of markers for detecting malignant potential was a panel of peptides from mucin-5AC and mucin-2, which could discriminate premalignant/malignant lesions from benign with an accuracy of 97% (95% CI, 89% to 99%) in the validation cohort. This result compared favorably with the accuracy of standard analyses: cyst fluid carcinoembryonic antigen (61%; 95% CI, 46% to 74%; P < .001) and cytology (84%; 95% CI, 71% to 92%; P = .02). A combination of proteins mucin-5AC and prostate stem-cell antigen could identify high-grade dysplasia/cancer with an accuracy of 96% (95% CI, 90% to 99%), and detected 95% of malignant/severely dysplastic lesions, compared with 35% and 50% for carcinoembryonic antigen and cytology ( P < .001 and P = .003, respectively). Conclusion Targeted mass spectrometry analysis of just three cyst fluid biomarkers provides highly accurate identification and assessment of cystic precursors to pancreatic adenocarcinoma. Additional studies should determine whether the method can facilitate timely cancer diagnosis, successful intervention, and prevention.

scholarly journals Simple mucinous cyst: another potential cancer precursor in the pancreas? Case report with molecular characterization and systematic review of the literature

2021 ◽  
Author(s):  
Anna Caterina Milanetto ◽  
Alice Sabrina Tonello ◽  
Giovanni Valotto ◽  
Giada Munari ◽  
Claudio Luchini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Cancer ◽  
English Literature ◽  
Correct Diagnosis ◽  
The Body ◽  
Cystic Lesions ◽  
Tail Region ◽  
Asymptomatic Patients ◽  
Gastric Type ◽  
Mucinous Cyst

AbstractCystic lesions of the pancreas may range from benign to precursors of pancreatic cancer. Simple mucinous cyst (SMC) is larger than 1 cm, has a gastric-type flat mucinous lining, and minimal atypia without ovarian-type stroma. We report a new case of pancreatic SMC, coupling a systematic review of the English literature mainly focused on their clinic-pathological features. We reviewed 103 cases of SMC in adults (73 women), averaging 57 (range, 26–70) years. The SMCs were located in the body-tail region of the pancreas in 60 (58%) cases, presenting as single cystic lesions in 94% of cases; 43% of patients were asymptomatic. A preoperative fine-needle aspiration of the cyst fluid detected amylase and carcinoembryonic antigen positivity in 71% and 76% of cases, respectively. Patients underwent surgery mostly for suspected malignancy; in 83% of cases, a standard pancreatic resection was performed. Mean SMC size was 4.9 (range, 1.5–12.0) cm. Mucins MUC5AC and MUC6 resulted positive in 77% and 81% of cases performed, respectively, whereas MUC2 was negative in all but one patient. The SMC from our institution was characterized by a KRAS somatic mutation. The diagnosis of SMC should be considered when a solitary pancreatic cyst larger than 1 cm is detected in asymptomatic patients. To establish a correct diagnosis, an extensive histologic/immunohistochemical analysis is essential. The presence of a KRAS mutation highlights that SMC may represent another potential pancreatic cancer precursor.

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