Fukuda Junko, Ikezawa Kenji, Nakao Miho, Okagaki Suetsumi, Ashida Reiko, Ioka Tatsuya, Takada Ryoji, Yamai Takuo, Fukutake Nobuyasu, Uehara Hiroyuki, Nagata Shigenori, Takahashi Hidenori, Tabuchi Takahiro, Tanaka Sachiko, Ohkawa Kazuyoshi, Katayama Kazuhiro
Department of Cancer Survey and Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka 541-8567, Japan.
Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, Osaka 541-8567, Japan.
Cancers (Basel). 2021 Jan 28;13(3):502. doi: 10.3390/cancers13030502.
Because pancreatic cancer has a dismal prognosis, a strategy for early diagnosis is required. This study aimed to identify predictive factors of neoplastic progression in patients at high risk for pancreatic cancer and examined the efficiency of surveillance using transabdominal special ultrasonography focusing on the pancreas (special pancreatic US). Patients with slight main pancreatic duct (MPD) dilatation (≥2.5 mm) and/or pancreatic cysts (≥5 mm) were enrolled in a prospective surveillance study with special pancreatic US in a Japanese cancer referral center. A total of 498 patients undergoing surveillance for ≥3 years were included. During the median follow-up of 5.9 years, neoplastic progression developed in 11 patients (2.2%), including 9 patients who underwent pancreatectomy. Eight patients (72.7%) were diagnosed with stage 0/I disease, with an overall survival duration of 8.8 years. Findings of both MPD dilatation and pancreatic cysts at initial surveillance, MPD growth (≥0.2 mm/year) and cyst growth (≥2 mm/year) during surveillance were identified as independent risk factors for neoplastic progression. In summary, surveillance with special pancreatic US for high-risk individuals contributed to earlier detection of neoplastic progression, leading to a favorable prognosis. During surveillance, attention should be paid to MPD growth as well as to cyst growth.
由于胰腺癌的预后很差，因此需要一种早期诊断策略。本研究旨在确定胰腺癌高危患者肿瘤进展的预测因素，并以胰腺为重点，通过经腹特殊超声检查（特殊胰腺超声）来评估监测的有效性。在日本一家癌症转诊中心，对主胰管（MPD）轻度扩张（≥2.5mm）和/或胰腺囊肿（≥5mm）的患者进行了一项采用特殊胰腺超声的前瞻性监测研究。共有498例接受了≥3年监测的患者纳入研究。在中位随访5.9年期间，11例患者（2.2%）发生了肿瘤进展，其中9例接受了胰腺切除术。8例患者（72.7%）被诊断为0/I期疾病，总生存时间为8.8年。初次监测时MPD扩张和胰腺囊肿的表现、监测期间MPD生长（≥0.2mm/年）和囊肿生长（≥2mm/年）被确定为肿瘤进展的独立危险因素。总之，对高危个体采用特殊胰腺超声进行监测有助于更早地发现肿瘤进展，从而带来良好的预后。在监测期间，应关注MPD生长以及囊肿生长。
