M1291 Familial Pancreatic Cancer: BRCA2, CDKN2A and CDk 4 Gene Alterations and Screening of Relatives

Abstract

pancreatitis, CCP), those without calcification but marked ductal changes according to Cambridge criteria (non-calcified chronic pancreatitis, NCCP), and those with mild ductal change on MRCP or mild parenchymal changes on endoscopic ultrasound (early stage chronic pancreatitis, ECP). Patients were considered lost to follow up when they failed to attend our hospital for more than one year. Standardized incidence ratio (SIR) was estimated as the ratio of the observed number of cases of pancreatic cancer in the cohort to the expected number of cases according to the age stratified and sex specific data provided by Center for Cancer Control and Information Services, National Cancer Center, Japan. The study was approved by the institutional review boards of our hospital. Results: Two hundred twenty patients (169 with CCP, 51 with NCCP, and 21 with ECP) were enrolled. The median follow-up in each group was 3.2, 3.1, and 1.2 years, respectively. Pancreatic cancer developed in 6 patients from CCP group alone, none in NCCP or ECP group. The expected number of cases was 0.20, yielding an SIR of 29.8 (CI 6.0-53.7) in CCP. The cumulative incidence of pancreatic cancer in CCP at 5 and 10 years were 6.8% and 10.3%, respectively. All of the cancer developed in the pancreas where the calcifications were observed. Although the cancer was diagnosed during regular follow-up in 3 cases, only one of them was surgically resected. Conclusion: Calcification in the pancreas is the risk factor of cancer incidence in chronic pancreatitis.