1. Value of repeated cytology for intraductal papillary mucinous neoplasms of the pancreas with high risk potential of malignancy: Is it a promising method for monitoring a malignant transformation?
- Author
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Takashi Tsuchiya, Yutaka Noda, Toshitaka Sakai, Yoshihide Kanno, Takahisa Ogawa, Kazuki Endo, Jun Horaguchi, Fumisato Kozakai, Hiroaki Kusunose, Kei Ito, Keisuke Yonamine, Takashi Sawai, Kazuaki Miyamoto, Shinsuke Koshita, Masaya Oikawa, Kaori Masu, and Toji Murabayashi
- Subjects
Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Pancreatic Intraductal Neoplasms ,Malignancy ,Risk Assessment ,Sensitivity and Specificity ,Malignant transformation ,03 medical and health sciences ,0302 clinical medicine ,Pancreatic Juice ,Cytology ,Humans ,Medicine ,Cyst ,Pancreas ,Aged ,Retrospective Studies ,Cholangiopancreatography, Endoscopic Retrograde ,Hepatology ,business.industry ,Gastroenterology ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Adenocarcinoma, Mucinous ,Pancreatic Neoplasms ,Cell Transformation, Neoplastic ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Pancreatic juice ,Female ,030211 gastroenterology & hepatology ,Radiology ,Tomography, X-Ray Computed ,business - Abstract
Objectives The efficacy of and indications for cytological reexamination to detect malignant changes in branch duct type intraductal papillary mucinous neoplasms (BD-IPMNs) have not been studied in detail. We conducted a retrospective study to evaluate the efficacy and indications of cytological reexamination by using pancreatic juice (repeated cytology) for BD-IPMNs. Methods Forty-five patients who underwent repeated cytology after a diagnosis of benignancy by using initial cytology were recruited for this study. Results Thirty-eight patients, excluding 7 patients with lack of surveillance period after the final cytology, were classified into Malignancy (n = 13) and Benignancy groups (n = 25) on the bases of the findings from resected specimens or changes in BD-IPMNs after repeated cytology. The sensitivity and specificity to detect malignant changes in BD-IPMNs by using repeated cytology were 62% and 100%, respectively. For the 12 patients with mural nodules (MNs) ≥ 5 mm (67% of them were malignant), the sensitivity was 50%, whereas, for the 26 patients without MNs ≥ 5 mm (19% of them were malignant), it was 80%. In addition, malignant changes in BD-IPMNs after initial cytology occurred in 62% of the patients with changes in the MNs and 27% of the patients with an increase in the cyst size. Conclusion Repeated cytology can play a role in the determination for surgery even after a diagnosis of benignancy by using initial cytology, especially for BD-IPMNs without MNs ≥5 mm. In addition, changes in the MNs or cyst size may be appropriate indications for repeated cytology.
- Published
- 2020