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キクヤマ マサタカ
Kikuyama Masataka
菊山 正隆 所属 医学部 医学科（東京女子医科大学病院） 職種 特任准教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Pancreatic duct epithelial malignancy suggested by large focal pancreatic parenchymal atrophy in cystic diseases of the pancreas. |
| 掲載誌名 | 正式名：Pancreatology 略 称：Pancreatology ISSNコード：14243911/14243903 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 23(4),pp.420-428 |
| 著者・共著者 | KIKUYAMA Masataka,NAKAHODO Jun,HONDA Goro,SUZUKI Mizuka,HORIGUCHI Shin-Ichiro,CHIBA Kazuro,TABATA Hiroki,OME Yusuke,UEMURA Shu-Ichiro,KAWAMOTO Yusuke,KAMISAWA Terumi |
| 担当区分 | 筆頭著者,責任著者 |
| 発行年月 | 2023/06 |
| 概要 | BACKGROUND:/Objectives: A cystic lesion is common in the pancreas. Focal pancreatic parenchymal atrophy (FPPA) has been reported as a sign of high-grade pancreatic intraepithelial neoplasia/carcinoma in situ (HGP/CIS). Some cystic lesions accompany FPPA. However, the relationship between a cystic lesion, FPPA, and the histopathological background of the pancreatic duct is unknown.METHODS:We retrospectively evaluated the data of 98 patients with a cystic lesion who underwent serial pancreatic juice aspiration cytologic examination (SPACE) because of accompanying FPPA, increased size of the cystic lesion, and pancreatic duct stricture at the base.RESULTS:The clinical diagnosis of a cystic lesion was intraductal papillary mucinous neoplasia (IPMN) and cysts in 72 (73.5%) and 26 (26.5%) patients, respectively. Ninety of the 98 patients (91.8%) had FPPA. Positive results (adenocarcinoma and suspicion) on SPACE were observed in 56 of all cases (57.1%), 48 of IPMN (66.7%), 8 of cysts (30.8%), and 54 of FPPA (59.3%), and were significantly associated with IPMN (p = 0.002) and the large FPPA (>269.79 mm2,p = 0.0001); moreover, these disorders are considerably related (p = 0.0003). Fifty patients (51.0%) with positive results on SPACE underwent surgery, with the histopathological diagnosis of epithelial malignancy in 42 patients (42.9%, 42/50, 84%). Many cystic lesions clinically diagnosed as IPMN were dilated branches covered by pancreatic intraepithelial neoplasia.CONCLUSIONS:Positive results on SPACE were significantly associated with the clinical diagnosis of IPMN and the large FPPA. Moreover, these disorders are significantly related. Surgery owing to positive results could lead to the histopathological diagnosis of HGP/CIS. |
| DOI | 10.1016/j.pan.2023.03.002 |
| PMID | 37003856 |