Program for the Investigation of Premalignant Lesions and Early Pancreatic Cancer in a High-Risk Population: Report From our First Year of Experience

Abstract

Introduction: Pancreatic cancer (PC) in early stages is potentially curable. High risk groups are as follows: 2 o more relatives with PC, one 1st grade relative <50 years old with PC, Peutz-Jeghers syndrome (PJS), Lynch syndrome and relative with PC, being carrier of a mutation in the BRCA2 gene and relative with PC, hereditary pancreatitis and chronic pancreatitis. The methods recommended for the diagnosis are the endosonography and annual nuclear magnetic cholangioresonance (NMCR). Objective: to detect premalignant lesions and pancreatic tumors in high risk population for PC. Methods: Multicenter and prospective study. Patients with high risk for PC were enrolled. We made a detailed medical history with a genogram and performed endosonography and NMCR. Results: During 2016, 25 patients were included, average age: 47.6 years, 15 of which were men. Risk factor: 13 patients with chronic pancreatitis, 11 patients with PC family background and 1 patient with PJS. We performed endosonography and found the following: 13 chronic pancreatitis patients, 1 atrophic pancreas, 1 pancreatic mass with guided puncture negative results for neoplasm with good evolution during the monitoring period, 1 intraductal papillary mucinous tumor (IPMN) and 10 normal studies. When NMCR was performed, the results were as follows: 7 patients with signs of chronic pancreatitis, 1 with increase of the pancreatic head, 1 with IPMN and 7 normal studies. The CA 19-9 was performed in 13 patients and only one of them had an altered level (x 2). Conclusion: During the first year of this program for the investigation of PC with endosonography and NMCR, no premalignant neoplasms were found; one premalignant lesion was diagnosed (IPMN).