Kikuyama Masataka, Nakahodo Jun, Chiba Kazuro, Honda Goro
Department of Gastroenterology, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Department of Gastroenterology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
Pancreatology. 2025 Mar;25(2):241-249. doi: 10.1016/j.pan.2025.01.003. Epub 2025 Jan 18.
BACKGROUND/OBJECTIVES: We previously reported that focal pancreatic parenchymal atrophy (FPPA) indicates high-grade pancreatic intraepithelial neoplasia (HG-PanIN) or carcinoma in situ (CIS). Because HG-PanIN progresses into pancreatic ductal adenocarcinoma (PDAC), the relationship between FPPA and PDAC should be investigated.
We included 54 patients with PDAC, whose previous computed tomography or magnetic resonance imaging were reviewed. The existence, positional relationship between FPPA and PDAC, and time between FPPA recognition and PDAC diagnosis were all examined. Of the 54 patients, 28 underwent surgery. The remaining 26 patients were histopathologically diagnosed with PDAC using endoscopic ultrasonography-guided fine needle aspiration.
Among the 54 patients included, 49 (83.3 %) had FPPA. The pancreatic head and body were the common sites of FPPA. In all patients with FPPA, PDAC developed near the FPPA, with an average distance of 7.93 mm between the edge of the FPPA and the center of the PDAC. The interval between FPPA recognition and PDAC diagnosis was 35.33 months, which was significantly shorter in the surgical group.
FPPA could be a precursor of PDAC and suggest the area at risk of PDAC.
背景/目的：我们之前报道过，局灶性胰腺实质萎缩（FPPA）提示高级别胰腺上皮内瘤变（HG-PanIN）或原位癌（CIS）。由于HG-PanIN会进展为胰腺导管腺癌（PDAC），因此应研究FPPA与PDAC之间的关系。
我们纳入了54例PDAC患者，并回顾了他们之前的计算机断层扫描或磁共振成像。检查了FPPA的存在情况、FPPA与PDAC之间的位置关系，以及FPPA识别与PDAC诊断之间的时间间隔。54例患者中，28例接受了手术。其余26例患者通过内镜超声引导下细针穿刺进行了PDAC的组织病理学诊断。
在纳入的54例患者中，49例（83.3%）有FPPA。胰头和胰体是FPPA的常见部位。在所有有FPPA的患者中，PDAC在FPPA附近发生，FPPA边缘与PDAC中心之间的平均距离为7.93毫米。FPPA识别与PDAC诊断之间的间隔为35.33个月，手术组明显更短。
FPPA可能是PDAC的前驱病变，并提示PDAC的风险区域。
