Abstract
Early detection of pancreatic cancer (PC) is essential for a better prognosis. Some recent studies have demonstrated that a slight dilatation of the main pancreatic duct (MPD) and small cystic lesions were detected initially in most cases diagnosed at an early stage. Detecting these abnormal findings in cases with high risk factors through an effective screening system including image diagnosis, some biological markers, or familial cancer registrations should contribute to early diagnosis of PC. It has been reported that endoscopic ultrasonography (EUS) is essential for detecting tumors <10 mm with a favorable prognosis. Additionally, EUS‐guided fine‐needle aspiration biopsy is useful for confirming final histological diagnosis. For the diagnosis of stage 0 PC, local irregular stenosis of MPD should be an important initial abnormal sign detected by EUS or magnetic resonance cholangiopancreatography. Cytodiagnosis multiple times using pancreatic juice obtained by endoscopic nasopancreatic drainage should be essential for the final diagnosis. Recently, activities of regional networks between specialist doctors in medical centers and general practitioners for early diagnosis of PC have been reported in Japan. In the future, these activities may play an important role in the early diagnosis of PC.
Highlights
Many patients with pancreatic cancer (PC) with a poor prognosis are diagnosed at an advanced stage
A case with the primary tumor of 10 mm has a probability of 28% of harboring metastases at diagnosis; as the primary tumor size increases to 20 mm and 30 mm, the risk of harboring metastases increases to 73 and 94%, respectively.[13]. These results suggest that PC of ≤10 mm with a low potential of metastasis and a favorable prognosis may be defined as ‘early PC’
In 2016, these hereditary diseases will be newly added to risk factors for PC in the revised clinical guidelines (CGL) issued by Japan Pancreas Society (JPS) Working Group (Table 3)
Summary
Many patients with pancreatic cancer (PC) with a poor prognosis are diagnosed at an advanced stage. Several initial screening studies using magnetic resonance imaging (MRI) or endoscopic ultrasonography (EUS) have been carried out in cases with genetic risk factors and syndromes, demonstrating some initial potential in identifying PC and premalignant lesions with malignant potential.[40,41,42] In 2016, these hereditary diseases will be newly added to risk factors for PC in the revised CGL issued by JPS Working Group (Table 3).
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